Individual
DANNY BARTON KILGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
305 PACIFIC AVE S STE C, KELSO, WA 98626-1638
(360) 425-5378
Mailing address
305 PACIFIC AVE S STE C, KELSO, WA 98626-1638
(360) 425-5378
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60278343
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164W00000X
—
AL
Enumeration date
06/14/2018
Last updated
06/14/2018
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