# KEVIN DOOMS MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174800593
- **Authorized official:** DR. KEVIN TODD DOOMS MD (PHYSICIAN, SOLE MEMBER)
- **Authorized official phone:** (425) 455-8391

## Contact information

- **Practice address:** 751 NE BLAKELY DR, ISSAQUAH, WA 98029-6201
- **Practice address phone:** (206) 223-9322
- **Practice address fax:** (425) 455-8391
- **Mailing address:** 901 BOREN AVE, SUITE 1730, SEATTLE, WA 98104-3595
- **Mailing address phone:** (206) 223-9322
- **Mailing address fax:** (425) 455-8391

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 603-140-833 | WA | Yes |

## Other

- **Enumeration date:** 11/14/2011
- **Last updated:** 11/14/2011