Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. KORDALE TRE BAVOR, NP
ActivePediatric Nurse Practitioner · BONNEY LAKE, WA
Registration Details
- NPI Number
- 1659984631
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 28, 2020 (5.6462325440503 yrs)
- Last Updated
- Aug 22, 2023
- License
-
61422757 (WA)
Practice Information
- Address
-
10004 204TH AVE E STE 1300BONNEY LAKE, WA, 983916537Browse WA providers · Browse ZIP 98391
- Phone
- 2538488797
- Primary Specialty
-
Pediatric Nurse Practitioner
363LP0200X
Other Pediatric Nurse Practitioner Providers in BONNEY LAKE, WA
| Name | Credential | NPI |
|---|---|---|
| SARAH B DICUGNO | ARNP | 1134106115 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.