Provider Demographics
NPI:1184493702
Name:SISKAR PLLC
Entity type:Organization
Organization Name:SISKAR PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KORISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMAGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-946-1192
Mailing Address - Street 1:2630 77TH AVE SE STE 102
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-3085
Mailing Address - Country:US
Mailing Address - Phone:206-946-1192
Mailing Address - Fax:833-615-2849
Practice Address - Street 1:2630 77TH AVE SE STE 102
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-3085
Practice Address - Country:US
Practice Address - Phone:206-946-1192
Practice Address - Fax:833-615-2849
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SISKAR PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-22
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty