Individual
DR. CHAD L KLEVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
870 11TH AVE, LONGVIEW, WA 98632-2402
(360) 425-4900
(360) 636-4641
Mailing address
870 11TH AVE, LONGVIEW, WA 98632-2402
(360) 425-4900
(360) 636-4641
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8719
WA
122300000X
Dentist
Primary
DE00008719
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201872862
TAX ID
WA
Enumeration date
05/25/2007
Last updated
03/22/2021
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