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General NPI Number Information
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NPI Number | 1801236971
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Entity Type | Individual
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Provider Name | MICHAEL KOLCZYNSKI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2013
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 5401 RIDGELINE DR
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City | KENNEWICK
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State | WA
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Zip | 99338-1822
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Country | US
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Telephone | 509-396-7966
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Fax |
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Provider Business Mailing Address
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Address Line | 3806 W 47TH AVE
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City | KENNEWICK
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State | WA
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Zip | 99337-2787
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Country | US
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Telephone | 312-608-5968
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | MD61095314
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 61095314
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 68437-20
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License Number State | WI
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