Provider Demographics
NPI:1568552008
Name:KAISER, FREDERICK S (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:S
Last Name:KAISER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3015 SQUALICUM PKWY
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1945
Mailing Address - Country:US
Mailing Address - Phone:360-733-4800
Mailing Address - Fax:360-733-2879
Practice Address - Street 1:3015 SQUALICUM PKWY
Practice Address - Street 2:SUITE 260
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1945
Practice Address - Country:US
Practice Address - Phone:360-733-4800
Practice Address - Fax:360-733-2879
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00021042207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8575904Medicaid
WAA09540Medicare UPIN
WA8575904Medicaid