Individual
MR. KEVIN C KOWALSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.D.
Contact information
Practice address
1521 LEIGH WAY, SUITE A, MOUNT VERNON, WA 98273-2403
(360) 848-7614
(360) 848-6355
Mailing address
1521 LEIGH WAY, SUITE A, MOUNT VERNON, WA 98273-2403
(360) 848-7614
(360) 848-6355
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
0254
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5032990
—
WA
01
—
891432
UNITED CONCORDIA
WA
Enumeration date
06/04/2007
Last updated
07/09/2007
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