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General NPI Number Information
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NPI Number | 1932468865
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Entity Type | Individual
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Provider Name | NATHAN ROBERT KENNEY PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/12/2012
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 2328 N 185TH ST UNIT D
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City | SHORELINE
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State | WA
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Zip | 98133-2300
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Country | US
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Telephone | 425-260-0045
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Fax |
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Provider Business Mailing Address
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Address Line | 2328 N 185TH ST UNIT D
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City | SHORELINE
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State | WA
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Zip | 98133-2300
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Country | US
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Telephone | 425-260-0045
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH60287806
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License Number State | WA
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