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Individual

KIM WARREN STONEKING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1718 E KESSLER BLVD, LONGVIEW, WA 98632-1842
(360) 747-5800
(360) 575-3846
Mailing address
PO BOX 3002, LONGVIEW, WA 98632-0302
(360) 747-5800
(360) 575-3846

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00048025
WA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0222573
LABOR & INDUSTRIES
WA
05
8486078
WA
01
8944963
CRIME VICTIMS
WA
01
P00416095
RAILROAD MEDICARE
Enumeration date
03/23/2007
Last updated
07/30/2012
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