NPI 1730331240

Brent Sissom, CRT

Practitioner Radiologic Technologist Puyallup, WA

Practice location

Address: 1519 3rd St SE Suite 103, Puyallup, WA 98372-3742
Phone: (253) 841-8939
Mailing address: 1519 3rd St SE Suite 101, Puyallup, WA 98372-3742

Registered specialties

Radiologic Technologist Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247100000X Licence RT00003985 (WA)

Other Radiologic Technologist providers in Washington →

Registry record

NPI: 1730331240
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Oct 2008
Record last updated: 15 Oct 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.