Individual
DR. KIRK LEIGH HALVORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2006 N 30TH ST APT 12, TACOMA, WA 98403-2955
(503) 702-5685
Mailing address
2006 N 30TH ST APT 12, TACOMA, WA 98403-2955
(503) 702-5685
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00004149
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2033785
—
WA
Enumeration date
07/02/2007
Last updated
06/11/2008
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