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General NPI Number Information
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NPI Number | 1477107837
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Entity Type | Individual
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Provider Name | KAYLA M VISCA
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Gender | Female
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Dates
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Enumeration Date | 07/24/2019
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 2150 N 107TH ST STE 480
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City | SEATTLE
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State | WA
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Zip | 98133-9009
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Country | US
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Telephone | 866-686-2504
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone | 719-538-2900
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Fax | 719-538-2990
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0007765
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA60956859
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License Number State | WA
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