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Mr. Kordale Tre Bavor, NP
Pediatric Nurse Practitioner in Bonney Lake, Washington
NPI 1659984631

Kordale Tre Bavor is a Pediatric Nurse Practitioner based in Bonney Lake, WA and is specialized in Pediatrics. Kordale Tre Bavor practices in Bonney Lake, WA and has the professional credentials of NP. The NPI Number for Kordale Tre Bavor is 1659984631 and holds a License No. 61422757 (Washington).

The current practice location address for Kordale Tre Bavor is 10004 204Th Ave E Ste 1300, Bonney Lake, WA and can be reached out via phone at 253-848-8797.

Location: 10004 204Th Ave E Ste 1300, Bonney Lake, WA, 98391-6537
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659984631
Provider Name
Kordale Tre Bavor
Credential
NP
Provider Entity Type
Individual
Gender
Male
Address
10004 204Th Ave E Ste 1300, Bonney Lake, WA, 98391-6537
Phone Number
253-848-8797
Fax Number
Provider Enumeration Date
08/28/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
10004 204Th Ave E Ste 1300
City
Bonney Lake
State
Washington
Zip
98391-6537
Phone Number
253-848-8797
Fax Number
person
Provider Business Mailing Address Details
Address
10004 204Th Ave E Ste 1300
City
Bonney Lake
State
Washington
Zip
98391-6537
Phone Number
253-848-8797
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
363LP0200X
License No.
61422757 (Washington)
Definition
Definition to come...
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