Provider Demographics
NPI:1124057682
Name:KESSLER, DAVID JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JOSEPH
Last Name:KESSLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2512 WHEATON WAY
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-3399
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2200 NW MYHRE RD
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7681
Practice Address - Country:US
Practice Address - Phone:360-830-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00024865207Y00000X, 207YS0123X, 207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
4286309OtherAETNA
KE6412OtherREGENCE BLUESHIELD
WA75435OtherLABOR & INDUSTRIES
WA1034453Medicaid
WA8913055OtherCRIME VICTIMS COMP
040002009OtherRAILROAD MEDICARE
040002009OtherRAILROAD MEDICARE
AK1790268OtherDEA
WAG000250421Medicare PIN
WAG115136425Medicare PIN
G8895443Medicare PIN
KE6412OtherREGENCE BLUESHIELD
WA8913055OtherCRIME VICTIMS COMP
4286309OtherAETNA
A07040Medicare UPIN
WA1034453Medicaid
WAG000250639Medicare PIN