Individual
KENNETH BRACONNIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5301 TIETON DR, SUITE C, YAKIMA, WA 98908-3479
(509) 965-7100
Mailing address
5301 TIETON DR, SUITE C, YAKIMA, WA 98908-3479
(509) 965-7100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60145197
WA
Other
Enumeration date
02/22/2017
Last updated
02/22/2017
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