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Individual

DR. KENNETH ROBERT STIVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8585 HARBORVIEW RD UNIT 6, BLAINE, WA 98230-9684
(707) 832-3734
Mailing address
8585 HARBORVIEW RD UNIT 6, BLAINE, WA 98230-9684
(707) 832-3734

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G28027
CA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
MD60996184
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G280270
CA
Enumeration date
08/01/2007
Last updated
02/05/2026
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