Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 25126 | WA |
Y | 208600000X | Surgeon | 25126 | WA |
NPI | 1003978644 |
---|---|
Provider Name | Dr. Robert D. Kugel |
First Address | Chehalis, WA 98532-8956 |
Second Address | Olympia, WA 98506-5069 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |