Individual
KIRK DAWSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
202 CULLENS ST NW, YELM, WA 98597-9417
(360) 458-7761
(360) 458-6612
Mailing address
4570 AVERY LN SE, STE C-180, LACEY, WA 98503
(360) 528-7122
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00001279
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073360
—
WA
01
—
72333
L&I
WA
01
—
DA7849
REGENCE
WA
Enumeration date
05/22/2006
Last updated
02/06/2020
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