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Contact Information

KENNETH D COMMON, OD
625 BLACK LAKE BLVD SW
SUITE #110
OLYMPIA, WA98502-5066
 Phone: 360-357-2544
 Fax: 360-357-6341
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for KENNETH D COMMON · (Male)

NPI # 1851402085
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 08/31/2006
Last updated 05/21/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • WA License # 1155TX
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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