Provider Demographics
NPI:1679279061
Name:SIESSER, EMILY IVEY (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:IVEY
Last Name:SIESSER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 E PLAYER DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-9534
Mailing Address - Country:US
Mailing Address - Phone:509-850-2955
Mailing Address - Fax:206-922-8001
Practice Address - Street 1:2721 E PLAYER DR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-9534
Practice Address - Country:US
Practice Address - Phone:509-850-2955
Practice Address - Fax:206-922-8001
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60439971163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty