Individual
KENNETH R BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1708 YAKIMA AVE, STE 110, TACOMA, WA 98405-5307
(253) 627-9151
Mailing address
1708 YAKIMA AVE, STE 110, TACOMA, WA 98405-5307
(253) 627-9151
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO00000585
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0158901
STATE L&I
WA
01
—
0226419
STATE L&I
WA
01
—
158900
STATE L&I
WA
01
—
480033767
MEDICARE RAILROAD
WA
01
—
480033768
MEDICARE RAILROAD
WA
05
—
8311193
—
WA
01
—
8936260
STATE CRIME VICTIMS
WA
01
—
8936261
STATE CRIME VICTIMS
WA
Enumeration date
07/07/2006
Last updated
11/16/2010
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