Provider Demographics
NPI:1295059525
Name:KISER, VERENNA (RPH)
Entity type:Individual
Prefix:
First Name:VERENNA
Middle Name:
Last Name:KISER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 32ND AVE W
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199-4044
Mailing Address - Country:US
Mailing Address - Phone:206-282-2881
Mailing Address - Fax:206-282-2817
Practice Address - Street 1:2222 32ND AVE W
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98199-4044
Practice Address - Country:US
Practice Address - Phone:206-282-2881
Practice Address - Fax:206-282-2817
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00020171183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist