Individual
KEVIN JON MOLANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 W TIETAN ST, WALLA WALLA, WA 99362-4445
(509) 525-3720
(509) 522-1593
Mailing address
55 W TIETAN ST, WALLA WALLA, WA 99362-4445
(509) 525-3720
(509) 522-1593
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00046086
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000443
—
WA
05
—
1013975036
—
WA
01
—
P01287754
RR MEDICARE
WA
Enumeration date
05/01/2006
Last updated
03/17/2018
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