Individual
MR. MIKHAIL Y ZISKIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1141 BEACH DR E, RETSIL, WA 98378-8366
(360) 895-4700
Mailing address
8016 56TH STREET CT W, UNIVERSITY PLACE, WA 98467-3955
(253) 756-2531
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
MD00040809
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8417339
—
WA
Enumeration date
01/13/2006
Last updated
07/08/2007
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