Bolland, Kevin J

Bolland, Kevin J is an individual health care provider with primary practice located at 10828 Gravelly Lake Dr Sw , Lakewood WA 98499-1334. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Bolland, Kevin J can be contacted via phone (360) 436-6594.

Contact Information

Primary practice address
10828 Gravelly Lake Dr Sw Lakewood WA 98499-1334
Phone: (360) 436-6594
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA10003177 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA10003177 Washington

Profile Details

NPI number 1962543033
LBN Legal business name Bolland, Kevin J
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2007
Last updated Dec 3rd, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962543033 NPPES
Washington Other 188614 LABOR AND INDUSTRIES

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