Individual
MR. KENNETH ROBERT LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CP00004923
Contact information
Practice address
9412 W 5TH PL, KENNEWICK, WA 99336-9603
(509) 396-7510
Mailing address
9412 W 5TH PL, KENNEWICK, WA 99336-9603
(509) 396-7510
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CP00004923
WA
Other
Enumeration date
06/04/2009
Last updated
06/04/2009
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