Individual
DR. BRIAN A. KENDREGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 E. KINCAID ST., MOUNT VERNON, WA 98274
(360) 428-2586
(360) 428-6470
Mailing address
1400 E. KINCAID STREET, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD14316
OR
207RP1001X
Pulmonary Disease Physician
Primary
MD00047370
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198234
—
OR
01
—
263567
LABOR & INDUSTRIES
WA
Enumeration date
06/16/2005
Last updated
01/11/2011
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