CRISWELL ALLEN KENNEDY M.D. NPI 1912122847

NPI Information

  • NPI: 1912122847
  • Provider Name: CRISWELL ALLEN KENNEDY, M.D.
  • Classification: General Practice - 208D00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 24128 E ALKI LN
    LIBERTY LAKE, WA
    ZIP 99019
  • Phone: (509) 255-5065

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NPI Details

Criswell Allen Kennedy, M.D. is a general practice in Liberty Lake, WA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee Criswell Allen Kennedy, M.D. NPI is 1912122847. 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:

24128 E ALKI LN
LIBERTY LAKE, WA
ZIP 99019-447
Phone: (509) 255-5065
Fax: (509) 477-6352

The NPI 1912122847 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/16/2007 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
1208D00000XGeneral PracticeMD00017804WASHINGTONYes

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: 11/21/2025

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