Provider Demographics
NPI:1417012873
Name:COLE, KENNETH CLAIRE JR (PSYD)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:CLAIRE
Last Name:COLE
Suffix:JR
Gender:M
Credentials:PSYD
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Mailing Address - Street 1:6917 W GRANDRIDGE BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7737
Mailing Address - Country:US
Mailing Address - Phone:509-737-9009
Mailing Address - Fax:509-737-9010
Practice Address - Street 1:6816 W. RIO GRANDE AVE.
Practice Address - Street 2:SUITE D
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336
Practice Address - Country:US
Practice Address - Phone:509-737-9009
Practice Address - Fax:509-737-9010
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2022-07-27
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Provider Licenses
StateLicense IDTaxonomies
WAPY60242645103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical