Healthcare Provider Details

I. General information

NPI: 1649194549
Provider Name (Legal Business Name): KINDRA K CAGLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KINDRA DAUN KING

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 N 20TH AVE
PASCO WA
99301-3393
US

IV. Provider business mailing address

4114 W KENNEWICK AVE APT A
KENNEWICK WA
99336-2840
US

V. Phone/Fax

Practice location:
  • Phone: 509-792-1041
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: