Individual
KENT ALAN FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2320 FREEWAY DRIVE, SKAGIT REGIONAL CLINICS - RIVERBEND ORTHOPEDICS, MOUNT VERNON, WA 98273
(360) 814-6800
(360) 814-6917
Mailing address
1400 E. KINCAID STREET, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA158179
OR
363A00000X
Physician Assistant
PA60188670
WA
363AM0700X
Medical Physician Assistant
0796
SD
363AM0700X
Medical Physician Assistant
PA60188670
WA
363AS0400X
Surgical Physician Assistant
Primary
PA60188670
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013217751
—
WA
Enumeration date
10/28/2010
Last updated
09/04/2020
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