Healthcare Provider Details

I. General information

NPI: 1508048604
Provider Name (Legal Business Name): PATRICK FLOWIN KENDRICK LMP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 11/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12811 SE 38TH ST
BELLEVUE WA
98006-1326
US

IV. Provider business mailing address

12811 SE 38TH ST
BELLEVUE WA
98006-1326
US

V. Phone/Fax

Practice location:
  • Phone: 425-378-1800
  • Fax:
Mailing address:
  • Phone: 425-378-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberMA8552
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: