Provider Demographics
NPI:1467838524
Name:MCKIERNAN, ERIN KEIKO KEHAULANI
Entity Type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:KEIKO KEHAULANI
Last Name:MCKIERNAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7121 TREEMONT LN NE
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-9577
Mailing Address - Country:US
Mailing Address - Phone:360-271-9850
Mailing Address - Fax:
Practice Address - Street 1:7121 TREEMONT LN NE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-9577
Practice Address - Country:US
Practice Address - Phone:360-271-9850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst