Provider Demographics
NPI:1114084746
Name:BEST, KEVIN EMERSON (LMP)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:EMERSON
Last Name:BEST
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11310 N NORMANDIE ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-3706
Mailing Address - Country:US
Mailing Address - Phone:509-467-5400
Mailing Address - Fax:509-468-9703
Practice Address - Street 1:11310 N NORMANDIE ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-3706
Practice Address - Country:US
Practice Address - Phone:509-467-5400
Practice Address - Fax:509-468-9703
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013696171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0145790OtherL & I PROVIDER NUMBER
WAMA00013696OtherSTATE LICENSE NUMBER