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Individual
MR. KENNETH ALAN LONG
Active
Individual
MR. KENNETH ALAN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
602 876 041
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7144942
WASHINGTON PROVIDER NUMBER
WA
Enumeration date
08/13/2009
Last updated
08/13/2009
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