Provider Demographics
NPI:1649457326
Name:MORTON, KENNETH LAURENCE (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:LAURENCE
Last Name:MORTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:14655 BEL RED RD STE 203
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3900
Mailing Address - Country:US
Mailing Address - Phone:425-562-6135
Mailing Address - Fax:425-562-9085
Practice Address - Street 1:14655 BEL RED RD STE 203
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3900
Practice Address - Country:US
Practice Address - Phone:425-562-6135
Practice Address - Fax:425-562-9085
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA27312207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1101369Medicaid
WA1101369Medicaid
WA8870615Medicare PIN