Kenneth D. Common, O.d., P.s.

NPI #1811052798 in Olympia, Washington

Provider Information

NPI Number: 1811052798
Entity Type: Organization
Organization Name: Kenneth D. Common, O.d., P.s.
Primary Specialty: Clinic/Center
Enumeration Date: Dec 22, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 625 BLACK LAKE BLVD SW
Address 2: SUITE #110
City: Olympia
State: Washington
ZIP Code: 98502-5066
Phone: (360) 357-2544

Authorized Official

Name: DR. KENNETH DOUGLAS COMMON, O.D.
Title: PRESIDENT
Phone: (360) 357-2544

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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