Individual
MR. KENNETH ROY COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
400 REINIER RD, NORDLAND, WA 98358-9675
(360) 531-2432
(360) 860-6550
Mailing address
400 REINIER RD, NORDLAND, WA 98358-9675
(360) 531-2432
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00009355
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LW00009355
DEPARTMENT OF HEALTH
WA
Enumeration date
07/24/2019
Last updated
10/14/2024
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