Individual
HARLEY WREN KINYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCC-A
Contact information
Practice address
2200 NW MYHRE RD, SILVERDALE, WA 98383-7681
(360) 830-1100
Mailing address
9621 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8502
(360) 830-1204
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
CD000025516
WA
237600000X
Audiologist-Hearing Aid Fitter
CD00002516
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
158357
LABOR & INDUSTRIES
WA
01
—
640004426
RAILROAD MEDICARE
—
05
—
7108947
—
WA
01
—
7927357
AETNA
—
01
—
8918KI
REGENCE BLUE SHIELD
—
05
—
9052556
—
WA
Enumeration date
05/28/2006
Last updated
03/07/2018
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