Healthcare Provider Details

I. General information

NPI: 1104595347
Provider Name (Legal Business Name): LIVER INSTITUTE NORTHWEST PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2021
Last Update Date: 09/10/2021
Certification Date: 09/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3216 NE 45TH PL STE 212
SEATTLE WA
98105-4028
US

IV. Provider business mailing address

3216 NE 45TH PL STE 212
SEATTLE WA
98105-4028
US

V. Phone/Fax

Practice location:
  • Phone: 206-536-3030
  • Fax: 206-524-0749
Mailing address:
  • Phone: 206-536-3030
  • Fax: 206-524-0749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KRIS V KOWDLEY
Title or Position: DIRECTOR
Credential: MD
Phone: 206-536-3030