Individual
KENNETH L. HILLIARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1011 E MAIN, SUITE 101, PUYALLUP, WA 98372-6779
(253) 445-1682
(253) 770-3833
Mailing address
1011 E MAIN, SUITE 101, PUYALLUP, WA 98372-6768
(253) 445-1682
(253) 770-3833
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000267
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508506
—
WA
01
—
756480629
RAILROAD MEDICARE
—
01
—
HI0901
REGENCE BLUESHIELD
—
Enumeration date
09/14/2005
Last updated
02/10/2008
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