Provider Demographics
NPI:1528027448
Name:KINDER, ERIC ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ANTHONY
Last Name:KINDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19020 33RD AVE W STE 210
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4748
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W STE 210
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4748
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1501
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000411042085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0409420OtherL&I-RADIA REST OF WA
WA0409425OtherL&I-SOUTH SOUND RADIOLOGY
WA0409422OtherL&I-RADIA KING COUNTY
WA1012462Medicaid
WA0409423OtherL&I-SWEDISH RADIA EDMONDS
WA0409424OtherL&I-EVERGREEN RADIA
WA0405633OtherL&I-SEATTLE RADIOLOGY
WA7822109Medicaid