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General NPI Number Information
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NPI Number | 1275230609
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Entity Type | Individual
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Provider Name | KENDRA ELIZABETH MIKATARIAN KENT NP
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Gender | Female
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Dates
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Enumeration Date | 02/15/2023
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 1700 5TH ST SE STE 101
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City | PUYALLUP
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State | WA
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Zip | 98372-4607
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Country | US
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Telephone | 253-848-8797
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Fax |
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Provider Business Mailing Address
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Address Line | 112 RUSSELL RD S
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City | BREMERTON
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State | WA
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Zip | 98312-3499
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Country | US
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Telephone | 757-274-6571
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP61338308
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License Number State | WA
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