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General NPI Number Information
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NPI Number | 1336318088
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Entity Type | Organization
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Legal Business Name | RICHARD T KUBINIEC MD PS
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 03/04/2008
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Provider Practice Location Address
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Address Line | 11801 NE 65TH ST #A
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City | VANCOUVER
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State | WA
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Zip | 98662-5552
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Country | US
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Telephone | 360-892-0208
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Fax | 360-892-9081
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Provider Business Mailing Address
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Address Line | PO BOX 820523
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City | VANCOUVER
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State | WA
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Zip | 98682-0011
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Country | US
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Telephone | 360-892-0208
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Fax | 360-892-9081
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | RICHARD T KUBINIEC
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Credential | MD
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Telephone | 360-892-0208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD00034433
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License Number State | WA
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