Provider Demographics
NPI:1023499753
Name:ROEMER, KEVIN ALLAN (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ALLAN
Last Name:ROEMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 S 347TH PL
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6718
Mailing Address - Country:US
Mailing Address - Phone:253-927-4500
Mailing Address - Fax:
Practice Address - Street 1:1107 S 347TH PL
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6718
Practice Address - Country:US
Practice Address - Phone:253-927-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60575302111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor