Provider Demographics
NPI:1083237036
Name:KESTER, MATTHEW (EAMP, L AC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:KESTER
Suffix:
Gender:M
Credentials:EAMP, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1416
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-1416
Mailing Address - Country:US
Mailing Address - Phone:509-416-6352
Mailing Address - Fax:
Practice Address - Street 1:4849 TILLAMOOK DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-7000
Practice Address - Country:US
Practice Address - Phone:509-416-6352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60978329171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist