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Individual

MARK D KIVIAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 17TH AVE, STEA10C, SEATTLE, WA 98122-5711
(206) 860-6656
(206) 320-3396
Mailing address
PO BOX 84026, SEATTLE, WA 98124-8426
(206) 860-6656
(206) 320-3396

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD00010647
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1523406
WA
Enumeration date
12/21/2006
Last updated
02/18/2009
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