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Individual
DR. KEVIN S KENNEDY
Active
Individual
DR. KEVIN S KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
OP00001295
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1072040
—
WA
01
—
72498
DEPT OF LABOR & INDUSTRY
WA
01
—
KE4773
REGENCE BLUE SHIELD
WA
Enumeration date
07/17/2006
Last updated
07/20/2007
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