Organization
KIM PRUESS NEVINS MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM ELIZABETH PRUESS NEVINS MD (MD OWNER)
(425) 391-0313
Entity
Organization
Contact information
Practice address
450 NW GILMAN BLVD, STE 301A, ISSAQUAH, WA 98027
(425) 391-0313
(425) 837-8501
Mailing address
PO BOX 1225, ISSAQUAH, WA 98027-0047
(425) 391-0313
(425) 837-8501
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00038616
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC8003
RAILROAD MEDICARE
—
Enumeration date
01/18/2006
Last updated
05/31/2011
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