Organization
KEVIN DOOMS MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN TODD DOOMS MD (PHYSICIAN, SOLE MEMBER)
(425) 455-8391
Entity
Organization
Contact information
Practice address
751 NE BLAKELY DR, ISSAQUAH, WA 98029-6201
(206) 223-9322
(425) 455-8391
Mailing address
901 BOREN AVE, SUITE 1730, SEATTLE, WA 98104-3595
(206) 223-9322
(425) 455-8391
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
603-140-833
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548226285
TYPE-1 NPI
WA
Enumeration date
11/14/2011
Last updated
11/14/2011
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