Individual
MICHAEL S KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3901 HOYT AVE, EVERETT, WA 98201
(425) 339-5412
(425) 259-1164
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 339-5412
(425) 259-1164
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
MD00014525
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030002415
RAILROAD MEDICARE
WA
01
—
030004268
MEDICARE RAILROAD
WA
01
—
030004279
RAILROAD MEDICARE
WA
05
—
1005750
—
WA
01
—
111120483
MEDICARE
WA
01
—
120835
CIGNA DMERC
WA
01
—
KE7883
REGENCE
WA
Enumeration date
06/15/2006
Last updated
03/07/2019
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