Individual
KAI DACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9040 FITZSIMMONS DR, TACOMA, WA 98431-1000
(253) 968-1330
Mailing address
PO BOX 351, PERRY, ME 04667-0351
(207) 853-0644
(207) 853-2347
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
2155
ME
Other
Enumeration date
09/08/2008
Last updated
02/17/2016
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