Provider Demographics
NPI:1811021454
Name:ASHER, KENNETH NATHAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:NATHAN
Last Name:ASHER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 15TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4524
Mailing Address - Country:US
Mailing Address - Phone:206-322-4552
Mailing Address - Fax:206-328-7944
Practice Address - Street 1:620 15TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4524
Practice Address - Country:US
Practice Address - Phone:206-322-4552
Practice Address - Fax:206-328-7944
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1220103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAWA1220OtherPSYCHOLOGIST LICENSE NUMB