Individual
KAMOL LOHAVANICHBUTR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
307 S 13TH ST, SUITE 300, MOUNT VERNON, WA 98274-4100
(360) 336-9757
(360) 814-5237
Mailing address
1400 E. KINCAID ST., ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD00036595
WA
207RI0011X
Interventional Cardiology Physician
Primary
MD00036595
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8417024
—
WA
Enumeration date
06/16/2006
Last updated
03/12/2016
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