Individual
MR. KEVIN BARRY FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
210 S 11TH AVE, YAKIMA, WA 98902-3293
(509) 495-1151
(509) 495-1151
Mailing address
210 S 11TH AVE, YAKIMA, WA 98902-3293
(509) 495-1151
(509) 495-1151
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60427970
WA
363AM0700X
Medical Physician Assistant
2104
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0419110
LABOR AND INDUSTRIES
WA
05
—
2040154
—
WA
Enumeration date
01/21/2011
Last updated
04/29/2026
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