Provider Demographics
NPI:1770253023
Name:KISSER, SNESHANA V
Entity Type:Individual
Prefix:
First Name:SNESHANA
Middle Name:V
Last Name:KISSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SNESHANA
Other - Middle Name:V
Other - Last Name:KISSER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4705 NE 66TH AVE APT 48
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-2490
Mailing Address - Country:US
Mailing Address - Phone:503-341-8635
Mailing Address - Fax:
Practice Address - Street 1:4705 NE 66TH AVE APT 48
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-2490
Practice Address - Country:US
Practice Address - Phone:503-341-8635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171R00000X
171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty