Provider Demographics
NPI:1134334972
Name:KERBS, DAVID P
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:KERBS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 LAKE SHORE PLZ STE 1
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-3716
Mailing Address - Country:US
Mailing Address - Phone:425-827-1619
Mailing Address - Fax:
Practice Address - Street 1:60 LAKE SHORE PLZ STE 1
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-3716
Practice Address - Country:US
Practice Address - Phone:425-827-1619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000368171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist