MR. KENNETH LEO FLECK PA-C NPI 1417045857

NPI Information

NPI: 1417045857
Provider Name: MR. KENNETH LEO FLECK, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
910 TACOMA AVE S
TACOMA, WA
ZIP 98402
Phone: (253) 708-4033
Get Directions

MR. Kenneth Leo Fleck, PA-C is a medical physician assistant in Tacoma, WA. MR. Kenneth Leo Fleck, PA-C NPI is 1417045857. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

910 TACOMA AVE S
TACOMA, WA
ZIP 98402-104
Phone: (253) 708-4033
Fax: (253) 798-4043

The enumeration date for this NPI number is 10/11/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA10001613	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	GAB36263	MEDICAID	WASHINGTON
2	P8420	MEDICARE UPIN	WASHINGTON
3	GAB36263	MEDICARE ID-TYPE UNSPECIFIED	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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