Provider Demographics
NPI:1316915994
Name:HILL, KENT R (MD)
Entity type:Individual
Prefix:DR
First Name:KENT
Middle Name:R
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 835
Mailing Address - Street 2:
Mailing Address - City:FOX ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98333-0835
Mailing Address - Country:US
Mailing Address - Phone:253-301-9904
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE MAMC-CAFBHS MADIGAN ANNEX 9923A
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-7213
Practice Address - Country:US
Practice Address - Phone:253-968-4843
Practice Address - Fax:253-968-6888
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000306852084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAF89356Medicare UPIN