IndividualActive
Brad Kennedy, LMP
NPI 1356628630 · Contractor · Vancouver, WA
Provider details
- NPI number
- 1356628630
- Entity type
- Individual
- Primary specialty
- ContractorOther Service Providers
- Credential
- LMP
- Sex
- Male
- Sole proprietor
- Yes
- License
- MA60188011 (WA)
Specialties & taxonomies
Other Service Providers
Practice location
2402 Broadway St
Vancouver, WA 98663-3229
Phone: (360) 241-6630
Approximate (ZIP-level) locationGet directions
Mailing address
13502 Se Harold St
Portland, OR 97236-4149
Registry dates
- Enumerated
- 2011-11-15
- Last updated
- 2011-11-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.