Healthcare Provider Details

I. General information

NPI: 1215977863
Provider Name (Legal Business Name): KEVIN L MORRIS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 11/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3202 COLBY AVE SUITE E
EVERETT WA
98201-4324
US

IV. Provider business mailing address

616 N.CHELAN AVE
WENATCHEE WA
98801-2025
US

V. Phone/Fax

Practice location:
  • Phone: 425-259-0855
  • Fax:
Mailing address:
  • Phone: 509-662-2970
  • Fax: 509-665-9808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO00000436
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: