Individual
KENNETH P PERKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1740 COOKS HILL RD, CENTRALIA, WA 98531-9071
(360) 736-7623
(360) 736-4074
Mailing address
1740 COOKS HILL RD, CENTRALIA, WA 98531-9071
(360) 736-7623
(360) 736-4074
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00014368
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031982
L & I
WA
05
—
8303802
—
WA
Enumeration date
08/26/2005
Last updated
12/17/2009
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