Healthcare Provider Details

I. General information

NPI: 1447429840
Provider Name (Legal Business Name): R-K HOLDINGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2008
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 SE PARK CREST AVE SUITE A 130
VANCOUVER WA
98683-1304
US

IV. Provider business mailing address

705 SE PARK CREST AVE SUITE A 130
VANCOUVER WA
98683-1304
US

V. Phone/Fax

Practice location:
  • Phone: 360-891-3727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code292200000X
TaxonomyDental Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAREN JOHNSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 360-891-3727