Basic Information
| Provider Information | |||||||||
| NPI: | 1003901331 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SARGEANT | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 750 SWIFT BLVD | ||||||||
| Address2: | SUITE #5 | ||||||||
| City: | RICHLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 993523521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099436060 | ||||||||
| FaxNumber: | 5099463097 | ||||||||
| Practice Location | |||||||||
| Address1: | 13103 E MANSFIELD AVE | ||||||||
| Address2: | |||||||||
| City: | SPOKANE VALLEY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992161642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5098922700 | ||||||||
| FaxNumber: | 5098922740 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 06/03/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | MD00032127 | WA | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.