Provider Demographics
NPI:1861833543
Name:PENTLAND, KEN (ND)
Entity Type:Individual
Prefix:DR
First Name:KEN
Middle Name:
Last Name:PENTLAND
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 116TH AVE NE
Mailing Address - Street 2:201
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3097
Mailing Address - Country:US
Mailing Address - Phone:425-455-1700
Mailing Address - Fax:
Practice Address - Street 1:1940 116TH AVE NE
Practice Address - Street 2:201
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3097
Practice Address - Country:US
Practice Address - Phone:425-455-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60333897175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath