Individual
KENNETH LANCE VANKOOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPC
Contact information
Practice address
3320 AUBURN WAY N, AUBURN, WA 98002-1805
(253) 398-9567
(253) 999-5740
Mailing address
3704 MORRIS AVE S, RENTON, WA 98055-5737
(206) 507-8383
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/22/2022
Last updated
09/24/2024
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