Individual
MR. KENNETH ROBERT WARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AAS
Contact information
Practice address
2009 NE 117TH ST STE 101, VANCOUVER, WA 98686-4022
(360) 566-9112
Mailing address
2009 NE 117TH ST STE 101, VANCOUVER, WA 98686-4022
(360) 566-9112
(360) 993-3047
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00005993
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YA0400X
—
WA
Enumeration date
06/02/2008
Last updated
10/23/2018
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