Provider Demographics
NPI:1083057822
Name:KITCHENS, ALIN RAY JR (LMP)
Entity Type:Individual
Prefix:MR
First Name:ALIN
Middle Name:RAY
Last Name:KITCHENS
Suffix:JR
Gender:M
Credentials:LMP
Other - Prefix:
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Mailing Address - Street 1:231 SE BARRINGTON DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3200
Mailing Address - Country:US
Mailing Address - Phone:866-240-0808
Mailing Address - Fax:866-240-0808
Practice Address - Street 1:205 STEWARD ROAD
Practice Address - Street 2:SUITE 104
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273
Practice Address - Country:US
Practice Address - Phone:360-416-3322
Practice Address - Fax:360-416-3302
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2015-02-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMA60328543225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA103K00000XOtherL.E.A.P.S. AND BEYOND INC.