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Individual
DR. KENNETH LY
Active
Individual
DR. KENNETH LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
207Q00000X
Family Medicine Physician
OP00001670
WA
207Q00000X
Family Medicine Physician
Primary
P0068
TX
207QA0000X
Adolescent Medicine (Family Medicine) Physician
P0068
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124254
—
WA
Enumeration date
08/15/2006
Last updated
03/03/2026
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