MEDICARE: GEORGE KINA M.D.

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	207Q00000X	Family Medicine Physician	MD00015309	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
2	5991027	OTHER		AETNA
3	8932783	OTHER	WA	CRIME VICTIMS COMP
4	75436	OTHER	WA	LABOR & INDUSTRIES
5	KI9577	OTHER		REGENCE BLUE SHIELD

General Provider Information

NPI Number	:	1619924230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE KINA M.D.

Provider Business Mailing Address
First Line	:	2512 WHEATON WAY
Second Line	:
City	:	BREMERTON
State	:	WA
Zip	:	98310-3399
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19245 7TH AVE NE
Second Line	:
City	:	POULSBO
State	:	WA
Zip	:	98370-7504
Country	:	US
Telephone Number	:	360-782-3500
Fax Number	:

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

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	03/07/2023

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