KEVIN LA, PLLC (NPI# 1063922938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063922938 |
| Entity Type | Organization |
| Organization Name | KEVIN LA, PLLC |
| Other Organization Name | CANYON CREEK FAMILY & IMPLANT DENTISTRY |
| Practice Address |
4809 132nd St Se Ste A105 Everett WA 98208-6241 |
| Mailing Address |
17321 40th Ave Se Bothell WA 98012-5065 |
| Practice Telephone | 4255850805 |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2017-10-05 |
| Authorized Official Name | DR. KEVIN LA (OWNER) |
| Authorized Official Telephone | 2134487706 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Canyon Creek Family & Implant Dentistry | Doing Business As Name - Organization |
| Street Address |
4809 132ND ST SE STE A105 |
| City | EVERETT |
| State | WA |
| Zip Code | 98208-6241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790270296 | Kenneth Britt Dyer | Registered Nurse | 10333 19th Ave, Se, Ste #109, Everett, WA 98208 | 2018-06-27 |
| 1518482215 | Glacier Peak Healthcare, Inc. | Home Health | 10530 19th Ave Se Ste 201, Everett, WA 98208 | 2017-08-03 |
| 1114454865 | Aliza Kreisman | Registered Nurse | 11020 19th Avenue Se, Kaiser Permanente of Washington Seattle Care Clinic, Everett, WA 98208 | 2017-05-12 |
| 1902269418 | Clay Eakin | Counselor | 2732 Grand Evenue, Everett, WA 98208 | 2016-04-01 |
| 1467810259 | Elizabeth Anne Powley | Marriage & Family Therapist | 1920 100th Street Southeast, Bld C3, Everett, WA 98208 | 2016-02-08 |
| 1659745842 | Andrea Rose Bedlington | Pharmacist | 11407 33rd Dr. Se, Everett, WA 98208 | 2015-11-25 |
| 1396123865 | Sound Surgeons Pllc | Clinic/Center | 125 130th Street Se, 1st Floor, Everett, WA 98208 | 2015-05-15 |
| 1831576537 | Chris Sturgeon | Counselor | 10102 Meridian Ave, Everett, WA 98208 | 2015-05-01 |
| 1982011128 | James M Lee | Physical Therapist | 10821 19th Ave Se Ste 102, Everett, WA 98208 | 2014-07-21 |
| 1972937357 | Ronald Tracy | Dentist | 10315 19th Avenue Se Suite 110, Everett, WA 98208 | 2013-08-21 |
| Find all providers in zip 98208 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770130890 | Kcpp Community Outreach | Clinic/Center | 10121 Evergreen Way Ste 25-244, Everett, WA 98204-3885 | 2019-08-22 |
| 1386207579 | Alyssa Burns Dds, Pllc | Clinic/Center | 9801 27th Ave W, Everett, WA 98204-5057 | 2019-04-15 |
| 1891259081 | Bond Bond Pllc | Clinic/Center | 4608 Dogwood Dr Ste A, Everett, WA 98203-2000 | 2019-01-22 |
| 1174051346 | Pro Brite Dental | Clinic/Center | 948 Broadway, Everett, MA 02149-3128 | 2017-05-31 |
| 1518413327 | Joseph Madson Dmd Pllc | Clinic/Center | 3802 Colby Ave, 4th Floor, Everett, WA 98201 | 2016-08-31 |
| 1003286477 | William Webley Dds Pllc | Clinic/Center | 11802 Evergreen Way, Suite 104, Everett, WA 98204-4620 | 2015-09-29 |
| 1467877027 | Thomas R Montenero D.m.d.p.c. | Clinic/Center | 80 Chelsea St, Everett, MA 02149-3530 | 2014-02-19 |
| 1285944991 | Pacific Northwest Dental | Clinic/Center | 4367 Rucker Avenue, Everett, WA 98203 | 2010-10-15 |
| 1336772698 | Kim Trieu, Dds, Pllc | Clinic/Center | 2032 Colby Ave, Everett, WA 98201-2234 | 2020-02-14 |
| 1588219794 | Everett Workwell Dental Pllc | Clinic/Center | 826 Broadway, Everett, MA 02149-3027 | 2019-08-05 |
| Find all providers in EVERETT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.