Individual
KEITH M ULNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
840 E HILL AVE, MOSES LAKE, WA 98837-2238
(509) 765-0216
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
OP00001986
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0198084
L&I
WA
05
—
1932214699
—
WA
01
—
P01256545
RR MEDICARE
WA
Enumeration date
08/20/2006
Last updated
09/13/2022
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