Individual
DR. KENNETH J O'BARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6720 FORT DENT WAY, SUITE 110, TUKWILA, WA 98188-8508
(206) 242-3651
(206) 433-7946
Mailing address
6720 FORT DENT WAY, SUITE 110, TUKWILA, WA 98188-8508
(206) 242-3651
(206) 433-7946
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD00018701
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171941
LABOR & INDUSTRIES
WA
Enumeration date
02/09/2007
Last updated
07/08/2007
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