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Individual
KENNETH SALLAS
Active
Individual
KENNETH SALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004745
WA
363A00000X
Physician Assistant
PA54732
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9103236
WASH STATE LICENSE
WA
Enumeration date
10/16/2006
Last updated
04/21/2026
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