MEDICARE: MATTHEW KUEMPEL

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
1	101YM0800X	Mental Health Counselor	LH60817365	WA

General Provider Information

NPI Number	:	1790263630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW KUEMPEL

Provider Business Mailing Address
First Line	:	2262 DAPHNE AVE
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99352-4575
Country	:	US
Telephone Number	:	509-378-0377
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 COLUMBIA PARK TRL STE 104
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99352-4772
Country	:	US
Telephone Number	:	509-572-8876
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2018
Last Update Date	:	09/04/2023

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