Matheny, Keith Wayne
Matheny, Keith Wayne is an sole proprietor health care provider with primary practice located at 10803 Se Kent Kangley Rd Suite #100, Kent WA 98030-7194. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Matheny, Keith Wayne can be contacted via phone (253) 859-0658.Contact Information
Primary practice address
10803 Se Kent Kangley Rd Suite #100
Kent WA 98030-7194
Phone: (253) 859-0658
Fax: (253) 859-8052
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 5596 | Washington |
Profile Details
| NPI number | 1922087428 |
|---|---|
| LBN Legal business name | Matheny, Keith Wayne |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 12th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1922087428 | NPPES |
| Washington | Other | 56326 | LABOR & INDUSTRIES |
| Washington | Other | 5001581 | LABOR & INDUSTRIES |
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