Provider Demographics
NPI:1609062074
Name:PAT J KULPA MD PS
Entity type:Organization
Organization Name:PAT J KULPA MD PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAT
Authorized Official - Middle Name:J
Authorized Official - Last Name:KULPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-851-2922
Mailing Address - Street 1:PO BOX 2237
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335
Mailing Address - Country:US
Mailing Address - Phone:253-851-2922
Mailing Address - Fax:253-851-9487
Practice Address - Street 1:7282 STINSON AVE
Practice Address - Street 2:SUITE C
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335
Practice Address - Country:US
Practice Address - Phone:253-851-2922
Practice Address - Fax:253-851-9487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00026032207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8851301Medicare Oscar/Certification
WAB46515Medicare UPIN