Individual
DR. CARTER DAVID KIESAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3015 SQUALICUM PKWY, BELLINGHAM, WA 98225-1945
(360) 733-2092
(360) 733-4013
Mailing address
PO BOX 5096, BELLINGHAM, WA 98227-5096
(360) 733-2092
(360) 733-4013
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2009-00916
NC
207X00000X
Orthopaedic Surgery Physician
80869
AZ
207X00000X
Orthopaedic Surgery Physician
Primary
MD60125328
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0169KI
REGENCE
WA
01
—
0261214
L&I AND CRIME VICTIMS
WA
05
—
1972703908
—
WA
05
—
G8893183
—
WA
Enumeration date
07/18/2007
Last updated
11/19/2010
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