Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DD3166 | NM |
Y | 122300000X | Dentist | DEFC.DF.60476251 | WA |
N | 122300000X | Dentist | TD0014 | NM |
NPI | 1003844770 |
---|---|
Provider Name | Kimberly Marie Espinoza |
First Address | Seattle, WA 98195-6370 |
Second Address | Seattle, WA 98195-6370 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 08/07/2014 |