Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP60451438 | WA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 60451438 | WA |
NPI | 1003232794 |
---|---|
Provider Name | Cindy Kiefer |
First Address | Renton, WA 98057-2908 |
Second Address | Kent, WA 98030-5904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2014 |
Last Update Date | 29/12/2021 |