Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LH61094473 | WA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | CO60888753 | WA |
NPI | 1215543194 |
---|---|
Provider Name | Kimberly C Hamilton |
First Address | Seattle, WA 98103-6956 |
Second Address | Seattle, WA 98103-6956 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2020 |
Last Update Date | 07/12/2020 |