Individual
KENNETH R KOSKELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4409 NW ANDERSON HILL RD, SILVERDALE, WA 98383-6807
(360) 698-6630
(360) 698-7002
Mailing address
4409 NW ANDERSON HILL RD, SILVERDALE, WA 98383-6807
(360) 698-6630
(360) 698-7002
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD00038111
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0199376
LABOR AND INDUSTRIES
WA
05
—
1115062
—
WA
01
—
P00267733
RAILROAD MEDICARE
WA
Enumeration date
02/08/2006
Last updated
12/13/2007
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