Individual
OLGA VLADIMIROVNA KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4420 76TH ST NE, MARYSVILLE, WA 98270-3726
(360) 651-7490
Mailing address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01061208A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2021752
—
WA
Enumeration date
03/03/2006
Last updated
08/21/2018
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