Healthcare Provider Details

I. General information

NPI: 1912941907
Provider Name (Legal Business Name): MICHAEL KAPPELMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 10/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20518 MONUMENT RD. SW
VASHON WA
98070-6613
US

IV. Provider business mailing address

20518 MONUMENT RD. SW
VASHON WA
98070-6613
US

V. Phone/Fax

Practice location:
  • Phone: 206-463-4727
  • Fax:
Mailing address:
  • Phone: 206-463-4727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00019231
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: