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KENNETH D. COMMON O.D. P.S. NPI 1811052798


NPI Information

NPI: 1811052798
Provider Name: KENNETH D. COMMON, O.D., P.S.
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
625 BLACK LAKE BLVD SW
SUITE #110
OLYMPIA, WA
ZIP 98502
Phone: (360) 357-2544
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KENNETH D. COMMON, O.D., P.S. is a clinic center in Olympia, WA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). KENNETH D. COMMON, O.D., P.S. NPI is 1811052798. The provider is registered as an organization entity type.

The provider's business location address is:

625 BLACK LAKE BLVD SW
SUITE #110
OLYMPIA, WA
ZIP 98502-066
Phone: (360) 357-2544
Fax: (360) 357-6341

The provider's authorized official is Kenneth Douglas Common .
The authorized official title is President and has the following contact phone number (360) 357-2544.

The enumeration date for this NPI number is 12/22/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/Center1155WASHINGTONYes

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: 4/28/2024

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