Individual
JOHN KENNETH FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3407 E M ST, TACOMA, WA 98404-3931
(206) 275-9705
(425) 484-6425
Mailing address
PO BOX 111556, TACOMA, WA 98411-1556
(253) 686-8840
(253) 572-6632
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
PO00000753
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0177187
L&I
WA
05
—
1118249
—
WA
Enumeration date
08/23/2005
Last updated
04/30/2017
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