Individual
EDWARD MICHAEL KOSNOSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10002 SE 240TH ST, KENT, WA 98031-4839
(253) 852-2020
(253) 854-2020
Mailing address
10002 SE 240TH ST, KENT, WA 98031-4839
(253) 852-2020
(253) 854-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3410
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0213257
LABOR & INDUSTRIES
WA
05
—
1006117
—
WA
05
—
1012250
—
WA
05
—
1021416
—
WA
05
—
2027381
—
WA
01
—
DF8532
RAILROAD MEDICARE GROUP
WA
01
—
KO7760
REGENCE
WA
01
—
P00446408
RAILROAD MEDICARE INDIVIDUAL
WA
Enumeration date
07/27/2005
Last updated
04/17/2012
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