Provider Demographics
NPI:1902898661
Name:CURRY, KEN LEWIS (MD)
Entity Type:Individual
Prefix:
First Name:KEN
Middle Name:LEWIS
Last Name:CURRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 GAGE BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352
Mailing Address - Country:US
Mailing Address - Phone:509-942-3627
Mailing Address - Fax:509-942-2268
Practice Address - Street 1:1100 GOETHALS DRIVE
Practice Address - Street 2:SUITE F
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352
Practice Address - Country:US
Practice Address - Phone:509-942-2372
Practice Address - Fax:509-942-3273
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28489207RC0001X
WAMD60667064207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2065860Medicaid
CO01284892Medicaid
COCUE3718OtherBCBS
COE3718Medicare ID - Type Unspecified
COCO307049Medicare PIN
COCUE3718OtherBCBS
D93458Medicare UPIN
CO01284892Medicaid