Healthcare Provider Details

I. General information

NPI: 1952460776
Provider Name (Legal Business Name): BONNIE JENE KENDALL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BONNIE JENE HAUSER LCSW

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8524 W GAGE BLVD STE A-111
KENNEWICK WA
99336-8241
US

IV. Provider business mailing address

8524 W GAGE BLVD STE A-111
KENNEWICK WA
99336-8241
US

V. Phone/Fax

Practice location:
  • Phone: 509-627-0504
  • Fax:
Mailing address:
  • Phone: 509-627-0504
  • Fax: 509-627-0504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW122495
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL8437
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW00007462
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: