Individual
DR. KENNETH MICHAEL KINGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
PO BOX 577, BREWSTER, WA 98812-0577
(509) 689-2517
Mailing address
PO BOX 577, BREWSTER, WA 98812-0577
(509) 689-2517
(509) 689-2086
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD61498906
WA
207P00000X
Emergency Medicine Physician
P4471
TX
208600000X
Surgery Physician
P4471
TX
2086S0127X
Trauma Surgery Physician
P4471
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036126885
—
IL
Enumeration date
02/07/2007
Last updated
03/24/2025
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