Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD00035714 | WA |
Y | 207QS0010X | Family Doctor - Sports Medicine | MD00035714 | WA |
NPI | 1093890899 |
---|---|
Provider Name | Kimberly G Harmon |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 22/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
232910 | INTERNAL ID-MOTOR VEHICLE ID (01) | |
8218984 | (05) | WA |
F91263 | (02) |