Provider Demographics
NPI:1104111228
Name:JONER, KENNA L
Entity type:Individual
Prefix:
First Name:KENNA
Middle Name:L
Last Name:JONER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KENNA
Other - Middle Name:L
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 S HOWARD ST STE 321
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-3816
Mailing Address - Country:US
Mailing Address - Phone:509-838-4128
Mailing Address - Fax:509-838-4816
Practice Address - Street 1:7 S HOWARD ST STE 321
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3816
Practice Address - Country:US
Practice Address - Phone:509-838-4128
Practice Address - Fax:509-838-4816
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAC560224745101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor