Individual
KENNETH DOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
600 BROADWAY, SUITE 190, SEATTLE, WA 98122-5395
(206) 323-4040
(206) 324-0943
Mailing address
600 BROADWAY, SUITE 190, SEATTLE, WA 98122-5395
(206) 323-4040
(206) 324-0943
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
OI00000098
WA
224P00000X
Prosthetist
PS00000097
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9036963
—
WA
Enumeration date
08/13/2007
Last updated
08/13/2007
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