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NPI Code Detail

MEDICARE: KURT W KENOYER PA-C

MEDICARE: KURT W KENOYER PA-C
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
1363A00000XPhysician AssistantPA10004740WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12159KEOTHERWAREGENCE BLUESHIELD INS
29974KEOTHERWAREGENCE BLUESHIELD INS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
49749KEOTHERWAREGENCE BLUESHIELD INS
51599KEOTHERWAREGENCE BLUESHIELD INS
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396780979
Entity Type Code : Individual
Provider Name (Legal Business Name) : KURT W KENOYER PA-C
Provider Business Mailing Address
First Line : 6926 NE FOURTH PLAIN BLVD
Second Line :
City : VANCOUVER
State : WA
Zip : 98661-7254
Country : US
Telephone Number : 360-993-3000
Fax Number :
Provider Business Practice Location Address
First Line : 6926 NE FOURTH PLAIN BLVD
Second Line :
City : VANCOUVER
State : WA
Zip : 98661-7254
Country : US
Telephone Number : 360-993-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2006
Last Update Date : 03/07/2023

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Directions to “ KURT W KENOYER PA-C” Practice Location

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