Provider Demographics
NPI:1922618719
Name:KINNEY, ERIC CASEY (AUD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:CASEY
Last Name:KINNEY
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8808 N INDIAN TRAIL RD APT 4201
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-9187
Mailing Address - Country:US
Mailing Address - Phone:970-581-5295
Mailing Address - Fax:
Practice Address - Street 1:4815 N ASSEMBLY ST BLDG 41
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6185
Practice Address - Country:US
Practice Address - Phone:970-581-5295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2391231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist