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Individual

DR. KENNETH DOUGLAS COMMON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
625 BLACK LAKE BLVD SW, SUITE #110, OLYMPIA, WA 98502-5066
(360) 357-2544
(360) 357-6341
Mailing address
12804 SE 302ND ST, AUBURN, WA 98092-2172
(253) 887-9174

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1155TX
WA

Other

Enumeration date
08/31/2006
Last updated
05/21/2008
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