Basic Information
Provider Information
NPI: 1023070737
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KASH
FirstName: FREDERICK
MiddleName: F
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 19020 33RD AVE W STE 210
Address2:  
City: LYNNWOOD
State: WA
PostalCode: 980364748
CountryCode: US
TelephoneNumber: 4255631500
FaxNumber: 4255631374
Practice Location
Address1: 19020 33RD AVE W STE 210
Address2:  
City: LYNNWOOD
State: WA
PostalCode: 980364748
CountryCode: US
TelephoneNumber: 4255631500
FaxNumber: 4255631501
Other Information
ProviderEnumerationDate: 04/06/2006
LastUpdateDate: 10/10/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085N0700XMD60933328WAN Allopathic & Osteopathic PhysiciansRadiologyNeuroradiology
2085R0202XK0084TXN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202XMD60933328WAY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
040895701WAL&I-SEATTLE RADIOLOGYOTHER
213501905WA MEDICAID
040895401WAL&I-SWEDISH RADIA EDMONDSOTHER
040895501WAL&I-EVERGREEN RADIAOTHER
040895601WAL&I-SOUTH SOUND RADIOLOGYOTHER
040895101WAL&I-RADIA REST OF WAOTHER
10335990305TX MEDICAID
040895301WAL&I-RADIA KING CTYOTHER


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