Provider Demographics
NPI:1972749901
Name:KMET ENTERPRISES, PLLC
Entity Type:Organization
Organization Name:KMET ENTERPRISES, PLLC
Other - Org Name:PEAK PERFORMANCE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:KMET
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-213-2999
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642-0007
Mailing Address - Country:US
Mailing Address - Phone:360-213-2999
Mailing Address - Fax:
Practice Address - Street 1:2 S 56TH PL STE 204
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:WA
Practice Address - Zip Code:98642-3427
Practice Address - Country:US
Practice Address - Phone:360-213-2999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8852528Medicare UPIN