Provider Demographics
NPI:1033273891
Name:BRIGGS, KENNETH C (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:C
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 SUMMITVIEW AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3023
Mailing Address - Country:US
Mailing Address - Phone:509-452-0890
Mailing Address - Fax:
Practice Address - Street 1:1001 SUMMITVIEW AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3023
Practice Address - Country:US
Practice Address - Phone:509-452-0890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2659111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2015113Medicaid
WA0119709Medicare PIN
WAU35631Medicare UPIN