Provider Demographics
NPI:1376731059
Name:KAUFMAN, DAVID (RNA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:RNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 SE COLE RD
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-9258
Mailing Address - Country:US
Mailing Address - Phone:360-427-4003
Mailing Address - Fax:360-427-2734
Practice Address - Street 1:1420 SE COLE RD
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-9258
Practice Address - Country:US
Practice Address - Phone:360-427-4003
Practice Address - Fax:360-427-2734
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANA00129125376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide