Individual
KEVIN WILLSON WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1440 NE MERMAN DR, PULLMAN, WA 99163-5069
(406) 812-0551
Mailing address
1440 NE MERMAN DR, PULLMAN, WA 99163-5069
(406) 812-0551
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
367496
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4128555
HEALTHY MONTANA KIDS
MT
Enumeration date
08/14/2021
Last updated
08/14/2021
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