Provider Demographics
NPI:1588642003
Name:EPLEY, K. DAVID (MD)
Entity Type:Individual
Prefix:
First Name:K.
Middle Name:DAVID
Last Name:EPLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KENNETH
Other - Middle Name:DAVID
Other - Last Name:EPLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:11800 NE 128TH ST
Mailing Address - Street 2:SUITE 430
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7208
Mailing Address - Country:US
Mailing Address - Phone:425-823-3937
Mailing Address - Fax:425-823-7479
Practice Address - Street 1:11800 NE 128TH ST
Practice Address - Street 2:SUITE 430
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7208
Practice Address - Country:US
Practice Address - Phone:425-823-3937
Practice Address - Fax:425-823-7479
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00036319207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8228090Medicaid
180033374OtherRAILROAD MEDICARE
EP4302OtherREGENCE HEALTHCARE
WA0122940OtherLABOR & INDUSTRIES
WA8228090Medicaid
180033374OtherRAILROAD MEDICARE