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Individual

KENNETH C ELAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3927 RUCKER AVE, EVERETT, WA 98201-4833
(425) 339-5422
Mailing address
2930 MAPLE ST, EVERETT, WA 98201-3832
(425) 261-1500
(425) 261-1515

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00013741
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8142655
WA
Enumeration date
02/21/2007
Last updated
03/30/2021
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