MR. GUILLERMO VALES KENNEDY (NPI# 1679130322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679130322 |
| Entity Type | Individual |
| Full Name | MR. GUILLERMO VALES KENNEDY |
| Credential | PA-C |
| Practice Address |
1500 Continental Pl Mount Vernon WA 98273 |
| Mailing Address |
1401 S Laventure Rd Mount Vernon WA 98274-6033 |
| Practice Telephone | 3604247041 |
| Practice Fax Number | 3604242418 |
| Mailing Telephone | 3604247041 |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2019-09-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA60912831 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2137460 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1401 S Laventure Rd, Mount Vernon, WA 982746033 | 3604247041 | 3604242418 |
| 1630 Ne Valley Rd Apt D101, Pullman, WA 991634419 | 6465735979 |
| Street Address |
1500 CONTINENTAL PL |
| City | MOUNT VERNON |
| State | WA |
| Zip Code | 98273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760480545 | Patrick M Lyons | Orthopaedic Surgery | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2005-07-14 |
| 1235694936 | Kristen Erin Roberts | Physician Assistant | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2019-02-06 |
| 1528484490 | Caryn Anne Clippert | Physician Assistant | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2014-03-14 |
| 1629409297 | Proliance Surgeons, Inc., P.s. | Physical Medicine & Rehabilitation | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2013-12-09 |
| 1376988477 | Ryan James Nathe | Orthopaedic Surgery | 1500 Continental Pl, Mount Vernon, WA 98273 | 2013-05-02 |
| 1851666929 | Herbie Yung | Physical Medicine & Rehabilitation | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2012-03-21 |
| 1194024448 | Camille Lauren Connelly | Orthopaedic Surgery | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2011-03-24 |
| 1669426417 | Robert James Rogers | Physician Assistant | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2006-05-19 |
| 1932109691 | Ivory V Larry | Physician Assistant | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2005-07-26 |
| 1457350712 | Proliance Surgeons, Inc., P.s. | Clinic/Center | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2005-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710585849 | Stephanie Marie Partington | Physical Therapist | 1901 Hoad Road, Mount Vernon, WA 98273 | 2020-10-12 |
| 1447866165 | Jennifer I Campos | Interpreter | 1501 Sunset Pl., Unit B, Mount Vernon, WA 98273 | 2020-09-17 |
| 1487217345 | Nicholas Peter Goodman | Student in an Organized Health Care Education/Training Program | Attn: Internal Medicine Residency, 300 Hospital Parkway, Mount Vernon, WA 98273 | 2019-04-17 |
| 1023579430 | Joan Watkins Opyr | Registered Nurse | Telecare North Sound E&t, 7825 North Sound Drive, Sedro-woolley, WA 98273 | 2019-03-28 |
| 1588136188 | Nicholas Bryan Corp | Physical Therapy Assistant | 1901 Hoag Road, Mount Vernon, WA 98273 | 2018-12-20 |
| 1518437300 | Eyonna Mason | Case Manager/Care Coordinator | 1100 52nd St, Mount Vernon, WA 98273 | 2018-12-05 |
| 1023515400 | Evergreen Recovery Centers | Substance Abuse Rehabilitation Facility | 1905 Continental Place, Mount Vernon, WA 98273 | 2018-04-11 |
| 1104320480 | Stacy Anne Black | Marriage & Family Therapist | 2301 Old Hwy 99, Mt. Vernon, WA 98273 | 2018-03-21 |
| 1609387844 | Kerri Jesse | Massage Therapist | 210 N 23rd St, Mount Vernon, WA 98273 | 2017-10-16 |
| 1992225320 | Juana Cleek | Registered Nurse | 330 Pacific Place, Mount Vernon, WA 98273 | 2017-06-27 |
| Find all providers in zip 98273 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235694936 | Kristen Erin Roberts | Physician Assistant | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2019-02-06 |
| 1033688981 | Ashton Taylor De Cardenas | Physician Assistant | 2320 Freeway Dr, Mount Vernon, WA 98273 | 2018-11-21 |
| 1114419280 | Janelle A Shah | Physician Assistant | 1401 S Laventure Rd, Mount Vernon, WA 98274 | 2018-06-04 |
| 1700326824 | Shannan Theresa O'brien | Physician Assistant | 1401 S Laventure Rd, Mount Vernon, WA 98274-6033 | 2017-03-08 |
| 1083991202 | Peter John Frey | Physician Assistant | 2320 Freeway Dr, Mount Vernon, WA 98273-5445 | 2011-11-16 |
| 1225107089 | Samuel L Collins | Physician Assistant | 1400 E Kincaid St, Mount Vernon, WA 98274-4127 | 2006-11-07 |
| 1588757306 | Kristina L. Mullen | Physician Assistant | 2320 Freeway Drive, Mount Vernon, WA 98273 | 2006-10-02 |
| 1376656827 | Joey Alan Wegmann | Physician Assistant | 302 Broadway St, Mount Vernon, IL 62864-5116 | 2006-08-17 |
| 1598707218 | Carlos Aguero | Physician Assistant | 1401 S Laventure Rd, Mount Vernon, WA 98274-6033 | 2006-06-11 |
| 1558325167 | Erin Doherty Van Allen | Physician Assistant | 1400 E Kincaid St, Mount Vernon, WA 98274-4127 | 2006-04-12 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 98273 |
Please comment or provide details below to improve the information on MR. GUILLERMO VALES KENNEDY.
| 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.