Individual
W. KIRK MCANLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
7911 220TH ST SW, EDMONDS, WA 98026-7979
(206) 349-7564
Mailing address
7911 220TH ST SW, EDMONDS, WA 98026-7979
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A160076267
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110202258
BOC
—
Enumeration date
09/26/2017
Last updated
09/26/2017
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