Kevin Dale Adolf, DPM
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Kirkland, WA
NPI 1124256151 · NPPES record last updated Jul 23, 2013
Key facts
- NPI
- 1124256151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- PO60217479 (WA)
- Practice address
- 30 Lake Shore PLZ
Kirkland, WA 98033-6175 - Phone
- (425) 822-4325
- Fax
- (425) 777-2111
- NPI assigned
- Jun 29, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41000232A | IN | MD | Podiatrist |
| PO60217479 | WA | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dpmsaltonprwa LLC | Foot & Ankle Surgery | Past | Accepting new patients |
| Dpmleonheartprwa LLC | Foot & Ankle Surgery | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 41000232A | IN | |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | PO60217479 | WA | Yes |
Addresses
Primary practice location
30 Lake Shore PLZ
Kirkland, WA 98033-6175
Mailing address
25223 132ND PL SE
Kent, WA 98042-6615
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 281189 | Other | L&I |
Other providers in Kirkland, WA
- Erin Jean Addison
- Sean C Adelman
- Jennifer Jean Adkison
- Catherine A Adler
- Haimanot Admassu
- Megan Adrian
- Advanced Health Options
- Aequita Pharmacy LLC
- Aesthetic Dental Center
- Aesthetic Eye Associates Ambulatory Surgery Center PLLC
All providers in Kirkland, WA · Foot & Ankle Surgery Podiatrist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.