Derby, Kenneth Mark

Derby, Kenneth Mark is an individual health care provider with primary practice located at 1124 E 35Th Ave , Spokane WA 99203-3168. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Cognitive & Behavioral is his primary health care specialty. Derby, Kenneth Mark can be contacted via phone (509) 747-7460.

Contact Information

Primary practice address
1124 E 35Th Ave Spokane WA 99203-3168
Phone: (509) 747-7460
Fax: (509) 323-5965
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 2204 Washington
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2204 Washington

Profile Details

NPI number 1679611420
LBN Legal business name Derby, Kenneth Mark
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2007
Last updated Jul 8th, 2007 - about 17 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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