National Provider Identifier Database

KENNETH R BREWER, DPM – NPI #1760415657
Surgery, Foot & Ankle

Contact Information

KENNETH R BREWER, DPM
1708 YAKIMA AVE
STE 110
TACOMA, WA  98405-5307
Phone: 253-627-9151
Fax:
Website:
Specialty Taxonomy Code
* Surgery, Foot & Ankle 213ES0103X

* Indicates primary specialty

NPI Profile & details for KENNETH R BREWER

NPI Number 1760415657
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 07/07/2006
Last updated 11/16/2010 - About 16 years ago
Sole proprietor1 No
Identifiers
  • WA License #: PO00000585
  • WA Medicaid: 8311193
  • WA Other: 480033767 MEDICARE RAILROAD
  • WA Other: 480033768 MEDICARE RAILROAD
  • WA Other: 8936260 STATE CRIME VICTIMS
  • WA Other: 8936261 STATE CRIME VICTIMS
  • WA Other: 0158901 STATE L&I
  • WA Other: 0226419 STATE L&I
  • WA Other: 158900 STATE L&I
Hospital affiliation n/a

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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