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Organization

ELI KACZYNSKI MD PS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ELI NMI KACZYNSKI MD (CORPORATE PRESIDENT)
(509) 783-3161
Entity
Organization

Contact information

Practice address
2529 W FALLS AVE, KENNEWICK, WA 99336-3041
(509) 783-3161
(509) 783-3163
Mailing address
2529 W FALLS AVE, KENNEWICK, WA 99336-3041
(509) 783-3161
(509) 783-3163

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD00016765
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0017179
ST. IND
WA
05
1364306
WA
01
756181836
MEDICARE RAILROAD
WA
Enumeration date
09/27/2010
Last updated
08/10/2015
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