MEDICARE: ROBERT KENT KILLIAN MD, MPH

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
1	207QA0505X	Adult Medicine Physician	MD00033951	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578553053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT KENT KILLIAN MD, MPH

Provider Business Mailing Address
First Line	:	901 BOREN AVE
Second Line	:	SUITE 712
City	:	SEATTLE
State	:	WA
Zip	:	98104-3595
Country	:	US
Telephone Number	:	206-568-6320
Fax Number	:	206-329-2092

Provider Business Practice Location Address
First Line	:	901 BOREN AVE
Second Line	:	SUITE 712
City	:	SEATTLE
State	:	WA
Zip	:	98104-3595
Country	:	US
Telephone Number	:	206-568-6320
Fax Number	:	206-329-2092

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	05/25/2012

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