Harris, Kenneth A

Harris, Kenneth A is an sole proprietor health care provider with primary practice located at 611 S Chestnut Street, Suite A , Ellensburg WA 98926. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Harris, Kenneth A can be contacted via phone (509) 962-7390.

Contact Information

Primary practice address
611 S Chestnut Street, Suite A Ellensburg WA 98926
Phone: (509) 962-7390
Fax: (509) 925-6948
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD00015916 Washington
Allopathic & Osteopathic Physicians / Surgery 208600000X MD00015916 Washington

Profile Details

NPI number 1841277845
LBN Legal business name Harris, Kenneth A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 30th, 2005
Last updated Mar 28th, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841277845 NPPES
Washington MEDICAID 7079346
Washington MEDICAID 1948603
Washington Other 18531

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