Provider Demographics
NPI:1033263256
Name:LIN, KENNETH C (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:C
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:805 MADISON ST
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1172
Mailing Address - Country:US
Mailing Address - Phone:206-264-8100
Mailing Address - Fax:206-264-8689
Practice Address - Street 1:19200 NORTH KELSEY STREET
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1431
Practice Address - Country:US
Practice Address - Phone:425-339-2433
Practice Address - Fax:425-339-8273
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2013-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00047536207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0225607OtherL & I
WAG8870949OtherMEDICARE EOC-MONROE (NON KING CO.)