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Kyle Scott Ardavanis, MD
General Practice Physician in Tacoma, Washington
NPI 1578020590

Kyle Scott Ardavanis is a General Practice Physician based in Tacoma, WA. Kyle Scott Ardavanis practices in Tacoma, WA and has the professional credentials of MD. The NPI Number for Kyle Scott Ardavanis is 1578020590 and holds a License No. (Washington).

The current practice location address for Kyle Scott Ardavanis is 9040 Jackson Ave, Tacoma, WA and can be reached out via phone at 253-968-1790 and via fax at 253-968-1586.

Location: 9040 Jackson Ave, Tacoma, WA, 98431-0001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1578020590
Provider Name
Kyle Scott Ardavanis
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
9040 Jackson Ave, Tacoma, WA, 98431-0001
Phone Number
253-968-1790
Fax Number
253-968-1586
Provider Enumeration Date
02/26/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
9040 Jackson Ave
City
Tacoma
State
Washington
Zip
98431-1000
Phone Number
253-968-1790
Fax Number
253-968-1586
person
Provider Business Mailing Address Details
Address
9040 Jackson Ave
City
Tacoma
State
Washington
Zip
98431-1000
Phone Number
253-968-1790
Fax Number
253-968-1586
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
33287 (Nebraska)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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