Eisenberger, Kenneth
Eisenberger, Kenneth is an sole proprietor health care provider with primary practice located at 1303 S O St , Port Angeles WA 98363-1218. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Eisenberger, Kenneth can be contacted via phone (360) 626-1457.Contact Information
Primary practice address
1303 S O St
Port Angeles WA 98363-1218
Phone: (360) 626-1457
Fax: (360) 626-1457
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LW00005218 | Washington |
Profile Details
| NPI number | 1881694321 |
|---|---|
| LBN Legal business name | Eisenberger, Kenneth |
| Credentials | LICSW, DCSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 27th, 2005 |
| Last updated | Jan 23rd, 2024 - about 2 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 | 1881694321 | NPPES |
| Washington | MEDICAID | 8511768 | |
| Washington | Other | G8902184 |
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