Individual
MR. KEVIN DONALD CONWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
2700 SIMPSON AVE, SUITE 102, ABERDEEN, WA 98520-4335
(360) 581-2030
(360) 537-8756
Mailing address
PO BOX 286, MONTESANO, WA 98563-0286
(360) 581-2030
(360) 537-8756
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00017460
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0165584
STATE OF WA ID NUMBER
WA
01
—
CO6182
REGENCE PROVIDER NUMBER
WA
Enumeration date
02/12/2007
Last updated
07/08/2007
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