Provider Demographics
NPI:1508028788
Name:DOLL, KEMI MORENIKEJI (MD)
Entity Type:Individual
Prefix:
First Name:KEMI
Middle Name:MORENIKEJI
Last Name:DOLL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ADEFOLAKEMI
Other - Middle Name:MORENIKEJI
Other - Last Name:ONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:206-543-6420
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-598-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60657717207VX0201X
NC2013-01429207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1508028788Medicaid
WA8955198Medicare PIN