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NPI Code Detail

MEDICARE: TONI L KESTER LMP

MEDICARE:   TONI L KESTER  LMP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMA00015856WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15411KEOTHERWAREGENCE BLUE SHIELD

General Provider Information

NPI Number : 1821139874
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONI L KESTER LMP
Provider Business Mailing Address
First Line : PO BOX 97363
Second Line :
City : LAKEWOOD
State : WA
Zip : 98497-0363
Country : US
Telephone Number : 253-686-2004
Fax Number :
Provider Business Practice Location Address
First Line : 10100 BRIDGEPORT WAY SW
Second Line :
City : LAKEWOOD
State : WA
Zip : 98499-2302
Country : US
Telephone Number : 253-686-2004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2007
Last Update Date : 07/08/2007

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Directions to “ TONI L KESTER LMP” Practice Location

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