Individual
DR. KEVIN V CONNOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
600 OAKESDALE AVE SW, STE 104, RENTON, WA 98057-5226
(425) 228-5336
(425) 228-4540
Mailing address
600 OAKESDALE AVE SW, STE 104, RENTON, WA 98057-5226
(425) 228-5336
(425) 228-4540
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY00001058
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000106440
—
WA
Enumeration date
11/14/2005
Last updated
12/15/2015
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