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Organization

KIRK, SHERRIS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARITY CAMPBELL (CREDENTIALING)
(425) 775-1505
Entity
Organization

Contact information

Practice address
6470 NE MARSHALL RD, BAINBRIDGE ISLAND, WA 98110-1617
(206) 819-9605
Mailing address
6470 NE MARSHALL RD, BAINBRIDGE ISLAND, WA 98110-1617
(206) 819-9605

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
PO0000501
WA
335E00000X
Prosthetic/Orthotic Supplier
PO0000501
WA

Other

Enumeration date
08/11/2010
Last updated
08/11/2010
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