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General NPI Number Information
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NPI Number | 1083873061
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Entity Type | Organization
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Legal Business Name | HEALTHVISION INTERNATIONAL
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 2200 N 30TH ST SUITE 201
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City | TACOMA
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State | WA
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Zip | 98403-3364
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Country | US
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Telephone | 253-779-5858
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Fax | 253-779-5757
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Provider Business Mailing Address
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Address Line | 2200 N 30TH ST SUITE 201
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City | TACOMA
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State | WA
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Zip | 98403-3364
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Country | US
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Telephone | 253-779-5858
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Fax | 253-779-5757
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KENNETH LYNN BAKKEN
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Credential | D.O.
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Telephone | 253-779-5858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OP00000753
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License Number State | WA
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