Provider Demographics
NPI:1750761250
Name:BIGGS, KENNETH (CDP, CADC II)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:
Last Name:BIGGS
Suffix:
Gender:M
Credentials:CDP, CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 NE 93RD ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-5318
Mailing Address - Country:US
Mailing Address - Phone:360-513-5671
Mailing Address - Fax:
Practice Address - Street 1:3906 NE 93RD ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-5318
Practice Address - Country:US
Practice Address - Phone:360-513-5671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14-R-05101YA0400X
WACP 60341705101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)