Provider Demographics
NPI:1285715391
Name:POND, KEN C (LMP)
Entity type:Individual
Prefix:
First Name:KEN
Middle Name:C
Last Name:POND
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:27304 918 PRSE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338
Mailing Address - Country:US
Mailing Address - Phone:541-567-4470
Mailing Address - Fax:
Practice Address - Street 1:552 N COLORADO ST
Practice Address - Street 2:STE. 200
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7779
Practice Address - Country:US
Practice Address - Phone:509-736-6060
Practice Address - Fax:509-736-3939
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist