Individual
MR. KYLE THOMAS KREKOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
14720 MAIN ST NE, SUITE 109, DUVALL, WA 98019-8460
(425) 788-4889
(425) 844-6116
Mailing address
PO BOX 34036, SEATTLE, WA 98124-1036
(425) 899-3292
(425) 899-3269
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10005050
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8463747
—
WA
01
—
P00447839
MEDICARE RAILROAD
—
Enumeration date
09/16/2006
Last updated
06/17/2009
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