Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DE 60477522 | WA |
NPI | 1104117555 |
---|---|
Provider Name | Kari Ann Sims |
First Address | Seattle, WA 98125-5835 |
Second Address | Seattle, WA 98125-5835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2011 |
Last Update Date | 04/07/2014 |