Provider Demographics
NPI:1144465964
Name:VANKIRK, DAVID KENT (CCP)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:KENT
Last Name:VANKIRK
Suffix:
Gender:M
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 HANFORD ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-1681
Mailing Address - Country:US
Mailing Address - Phone:425-213-4149
Mailing Address - Fax:
Practice Address - Street 1:723 HANFORD ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-1681
Practice Address - Country:US
Practice Address - Phone:425-213-4149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS920320242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist