Provider Demographics
NPI:1255688842
Name:HATCHER, KENNETH B (IHTP/INLTP)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:B
Last Name:HATCHER
Suffix:
Gender:M
Credentials:IHTP/INLTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 JADWIN
Mailing Address - Street 2:STE 8
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352
Mailing Address - Country:US
Mailing Address - Phone:509-943-2315
Mailing Address - Fax:
Practice Address - Street 1:719 JADWIN AVE
Practice Address - Street 2:STE 15
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4217
Practice Address - Country:US
Practice Address - Phone:509-943-2315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601391066174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist