Individual
DEIRDRE K KIEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
318 CYPRESS ST, LONGVIEW, WA 98632-1729
(360) 261-2170
Mailing address
318 CYPRESS ST, LONGVIEW, WA 98632-1729
(360) 261-2170
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA00016645
WA
Other
Enumeration date
03/02/2013
Last updated
03/02/2013
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