Provider Demographics
NPI:1366592792
Name:KMET, CAMERON PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:PAUL
Last Name:KMET
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6204 NE HIGHWAY 99 STE C
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8746
Mailing Address - Country:US
Mailing Address - Phone:360-213-2999
Mailing Address - Fax:
Practice Address - Street 1:6204 NE HIGHWAY 99 STE C
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8746
Practice Address - Country:US
Practice Address - Phone:360-213-2999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7175411OtherAETNA
WA5743KMOtherBLUE CROSS BLUE SHEILD
WA0194616OtherLABOR AND INDUSTRIES
WA8852528Medicare ID - Type Unspecified
WA7175411OtherAETNA