Individual
KIMO MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AAC
Contact information
Practice address
16225 NE 87TH ST STE 160, REDMOND, WA 98052-3536
(206) 797-9080
Mailing address
6400 SOUTHCENTER BLVD, TUKWILA, WA 98188-2547
(206) 901-2000
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
457632614
—
WA
Enumeration date
01/15/2019
Last updated
11/17/2025
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