Provider Demographics
NPI:1124353156
Name:KEVIN L SLOAN, MD, PLLC
Entity type:Organization
Organization Name:KEVIN L SLOAN, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-829-9137
Mailing Address - Street 1:4731 84TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-4322
Mailing Address - Country:US
Mailing Address - Phone:206-375-2774
Mailing Address - Fax:
Practice Address - Street 1:4731 84TH AVE SE
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-4322
Practice Address - Country:US
Practice Address - Phone:206-829-9137
Practice Address - Fax:206-829-9410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-08
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000291322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty