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NPI Code Detail

MEDICARE: ELISABETH KINNEY

MEDICARE:   ELISABETH  KINNEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianCB61600402WA

General Provider Information

NPI Number : 1538986047
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISABETH KINNEY
Provider Business Mailing Address
First Line : 6409 E MILL PLAIN BLVD
Second Line :
City : VANCOUVER
State : WA
Zip : 98661-7454
Country : US
Telephone Number : 360-718-8376
Fax Number :
Provider Business Practice Location Address
First Line : 6409 E MILL PLAIN BLVD
Second Line :
City : VANCOUVER
State : WA
Zip : 98661-7454
Country : US
Telephone Number : 360-718-8376
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2024
Last Update Date : 01/20/2026

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Directions to “ ELISABETH KINNEY ” Practice Location

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