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General NPI Number Information
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NPI Number | 1598268666
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Entity Type | Organization
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Legal Business Name | KBO ANESTHESIA PLLC
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Dates
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Enumeration Date | 03/14/2018
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Last Update Date | 03/14/2018
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Provider Practice Location Address
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Address Line | 3637 NW BYRON ST
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City | SILVERDALE
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State | WA
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Zip | 98383-9127
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Country | US
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Telephone | 301-312-5026
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Fax |
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Provider Business Mailing Address
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Address Line | 3637 NW BYRON ST
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City | SILVERDALE
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State | WA
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Zip | 98383-9127
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Country | US
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Telephone | 301-312-5026
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ADAM OLSSON
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Credential | MD
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Telephone | 301-312-5026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 60321448
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License Number State | WA
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