Individual
CALISTA KU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
904 7TH AVE, SEATTLE, WA 98104
(206) 860-4669
(206) 860-2269
Mailing address
1145 BROADWAY FL 2, SEATTLE, WA 98122-4201
(206) 860-4669
(206) 860-2269
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60778925
WA
363LP2300X
Primary Care Nurse Practitioner
AP60778925
WA
Other
Enumeration date
08/31/2017
Last updated
10/23/2019
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