Harris, Kenneth A
Harris, Kenneth A is an sole proprietor health care provider with primary practice located at 611 S Chestnut Street, Suite A , Ellensburg WA 98926. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Harris, Kenneth A can be contacted via phone (509) 962-7390.Contact Information
Primary practice address
611 S Chestnut Street, Suite A
Ellensburg WA 98926
Phone: (509) 962-7390
Fax: (509) 925-6948
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | MD00015916 | Washington |
Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD00015916 | Washington |
Profile Details
NPI number | 1841277845 |
---|---|
LBN Legal business name | Harris, Kenneth A |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Dec 30th, 2005 |
Last updated | Mar 28th, 2012 - about 12 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1841277845 | NPPES |
Washington | MEDICAID | 7079346 | |
Washington | MEDICAID | 1948603 | |
Washington | Other | 18531 |
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