Individual
CRISWELL ALLEN KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24128 E ALKI LN, LIBERTY LAKE, WA 99019-9447
(509) 255-5065
(509) 477-6352
Mailing address
24128 E ALKI LN, LIBERTY LAKE, WA 99019-9447
(509) 255-5065
(509) 477-6352
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD00017804
WA
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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