Individual
DR. KENNY P KOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1330 ROCKEFELLER AVE, #120, EVERETT, WA 98201-1684
(425) 339-5442
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 339-5442
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD00033150
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002823
—
WA
Enumeration date
07/20/2006
Last updated
12/11/2012
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