DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: KGP LLC

MEDICARE: KGP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP60443753WA

General Provider Information

NPI Number : 1073939427
Entity Type Code : Organization
Provider Name (Legal Business Name) : KGP LLC
Provider Business Mailing Address
First Line : PO BOX 1898
Second Line :
City : ABERDEEN
State : WA
Zip : 98520-0315
Country : US
Telephone Number : 360-637-9263
Fax Number : 360-637-8732
Provider Business Practice Location Address
First Line : 319 E PIONEER AVE
Second Line :
City : MONTESANO
State : WA
Zip : 98563-4601
Country : US
Telephone Number : 360-249-1980
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KERRY PETERSON
Credential : FNP
Telephone Number : 360-249-1980
Provider Enumeration Date : 03/10/2014
Last Update Date : 03/10/2014

Similar Medicare Providers

1629021852 — LYNDA BRADY STAFFORD DO
Practice Location Address:
319 E PIONEER AVE
MONTESANO, WA
98563-4601
Practice Phone: 360-249-3300
Practice Fax:
1699700245 — DR. ROWENA MADERAZO CARATAO M.D.
Practice Location Address:
319 E PIONEER AVE
MONTESANO, WA
98563-4601
Practice Phone: 360-533-4599
Practice Fax: 360-537-6514
1306901475 — GRANT WELLS JACKSON MD
Practice Location Address:
319 E PIONEER AVE , GRANT W JACKSON MD PS
MONTESANO, WA
98563-4601
Practice Phone: 360-249-1980
Practice Fax: 360-249-1993
1023274370 — GRANT W JACKSON MD PS
Practice Location Address:
319 E PIONEER AVE
MONTESANO, WA
98563-4601
Practice Phone: 360-249-1980
Practice Fax:
1083084677 — GRAYS HARBOR COMMUNITY HOSPITAL
Practice Location Address:
319 E PIONEER AVE
MONTESANO, WA
98563-4601
Practice Phone: 360-249-3300
Practice Fax:
1275031304 — GRAYS HARBOR COMMUNITY HOSPITAL
Practice Location Address:
319 E PIONEER AVE
MONTESANO, WA
98563-4601
Practice Phone: 360-249-3300
Practice Fax:

Directions to “KGP LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.