Kent Vision Clinic | |
10002 Se 240th St Kent WA 98031-4839 | |
(253) 852-2020 | |
(253) 854-2020 |
Full Name | Kent Vision Clinic |
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Speciality | Clinic/Center |
Location | 10002 Se 240th St, Kent, Washington |
Authorized Official Name and Position | Edward M Kosnoski (OWNER) |
Authorized Official Contact | 2538522020 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Kent Vision Clinic Po Box 6609 Kent WA 98064-6609 Ph: (253) 852-2020 | Kent Vision Clinic 10002 Se 240th St Kent WA 98031-4839 Ph: (253) 852-2020 |
NPI Number | 1881774974 |
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Provider Enumeration Date | 10/16/2006 |
Last Update Date | 08/19/2010 |
Medicare PECOS PAC ID | 7618978859 |
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Medicare Enrollment ID | O20100930044826 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881774974 | NPI | - | NPPES |
DF8532 | Other | WA | RAILROAD MEDICARE |
1021416 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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