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Mr. Corey Lee Kisser
Student in an Organized Health Care Education/Training Program in Forest Grove, Oregon
NPI 1962762393

Corey Lee Kisser is a Student in an Organized Health Care Education/Training Program based in Forest Grove, OR. Corey Lee Kisser practices in Forest Grove, OR. The NPI Number for Corey Lee Kisser is 1962762393 and holds a License No. (Oregon).

The current practice location address for Corey Lee Kisser is 3541 17Th Ct, Forest Grove, OR and can be reached out via phone at 503-319-9763.

Location: 3541 17Th Ct, Forest Grove, OR, 97116-2102
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1962762393
Provider Name
Corey Lee Kisser
Credential
Provider Entity Type
Individual
Gender
Male
Address
3541 17Th Ct, Forest Grove, OR, 97116-2102
Phone Number
503-319-9763
Fax Number
Provider Enumeration Date
05/18/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3541 17Th Ct
City
Forest Grove
State
Oregon
Zip
97116-2102
Phone Number
503-319-9763
Fax Number
person
Provider Business Mailing Address Details
Address
3541 17Th Ct
City
Forest Grove
State
Oregon
Zip
97116-2102
Phone Number
503-319-9763
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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