Brooks, Kenna Marie

Brooks, Kenna Marie is an individual health care provider with primary practice located at 612 Woodland Square Loop Se Ste 401 , Lacey WA 98503-1070. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Brooks, Kenna Marie can be contacted via phone (360) 999-9053.

Contact Information

Primary practice address
612 Woodland Square Loop Se Ste 401 Lacey WA 98503-1070
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X CG60792062 Washington
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1033631668
LBN Legal business name Brooks, Kenna Marie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2017
Last updated Mar 1st, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033631668 NPPES
Washington MEDICAID 1033631668
Washington Other 1780913657

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