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Individual

KENNETH CASE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CDPT

Contact information

Practice address
305 PACIFIC AVE S STE 102, KELSO, WA 98626-1638
(360) 577-7442
Mailing address
PO BOX 1847, LONGVIEW, WA 98632-8140
(360) 423-0203
(360) 577-0269

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
60607298
WA

Other

Enumeration date
09/01/2017
Last updated
11/21/2019
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