Provider Demographics
NPI:1932468865
Name:KENNEY, NATHAN ROBERT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ROBERT
Last Name:KENNEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2328 N 185TH ST UNIT D
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-2300
Mailing Address - Country:US
Mailing Address - Phone:425-260-0045
Mailing Address - Fax:
Practice Address - Street 1:2328 N 185TH ST UNIT D
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-2300
Practice Address - Country:US
Practice Address - Phone:425-260-0045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-12
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60287806183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist