Eisenberger, Kenneth

Eisenberger, Kenneth is an sole proprietor health care provider with primary practice located at 1303 S O St , Port Angeles WA 98363-1218. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Eisenberger, Kenneth can be contacted via phone (360) 626-1457.

Contact Information

Primary practice address
1303 S O St Port Angeles WA 98363-1218
Fax: (360) 626-1457
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LW00005218 Washington

Profile Details

NPI number 1881694321
LBN Legal business name Eisenberger, Kenneth
Credentials LICSW, DCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 27th, 2005
Last updated Jan 23rd, 2024 - about last year

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 1881694321 NPPES
Washington MEDICAID 8511768
Washington Other G8902184

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