Provider Demographics
NPI:1093026155
Name:KINNEY, PATRICK O (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:O
Last Name:KINNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:190 E BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6241
Mailing Address - Country:US
Mailing Address - Phone:208-381-2222
Mailing Address - Fax:206-233-7489
Practice Address - Street 1:1401 MADISON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1316
Practice Address - Country:US
Practice Address - Phone:206-386-6111
Practice Address - Fax:206-386-6113
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2014-10-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDM-11510207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine