Individual
KENNETH DYBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1012 S 3RD ST, DAYTON, WA 99328-1606
(509) 382-2531
(509) 382-3209
Mailing address
1012 S 3RD ST, DAYTON, WA 99328-1606
(509) 382-2531
(509) 382-3209
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA10001137
WA
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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