Basic Information
Provider Information
NPI: 1326000407
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KUHLE
FirstName: WILLIAM
MiddleName: G
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: 400 NE MOTHER JOSEPH PL
Address2:  
City: VANCOUVER
State: WA
PostalCode: 986643200
CountryCode: US
TelephoneNumber: 3608929664
FaxNumber: 3608929667
Other Information
ProviderEnumerationDate: 04/04/2006
LastUpdateDate: 01/24/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XMD00044354WAY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
829678205WA MEDICAID
100764505WA MEDICAID
038345901WALNI-RADIAOTHER
28752605OR MEDICAID


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