Individual
DARYL GENE CONKLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
108 KINDLE RD, RANDLE, WA 98377-1411
(360) 497-3333
(360) 497-5073
Mailing address
233 WILLAIMS AVE, PO BOX 508, MOSSYROCK, WA 98564-0508
(360) 983-3069
(360) 983-3098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10002577
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1100687
COMMUNITY HEALTH
WA
05
—
8374738
—
WA
01
—
CO3874
REGENCE RIDER
WA
Enumeration date
09/11/2006
Last updated
07/09/2007
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