Provider Demographics
NPI:1275830259
Name:KENNER, CARRIE (CD(DONA))
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:KENNER
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5307 S ALASKA ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-1526
Mailing Address - Country:US
Mailing Address - Phone:206-725-7758
Mailing Address - Fax:
Practice Address - Street 1:5307 S ALASKA ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-1526
Practice Address - Country:US
Practice Address - Phone:206-725-7758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2029374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula