Individual
KIM R PITTENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13014 120TH AVE NE, KIRKLAND, WA 98034-3015
(425) 821-8004
Mailing address
1100 9TH AVE, MS:M4-PA, SEATTLE, WA 98101-2756
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00022740
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039581
LABOR & INDUSTRY
WA
01
—
080149619
RAILROAD MEDICARE
—
05
—
8000283
—
WA
01
—
PI2560
BLUE SHIELD
WA
01
—
US4120143
AETNA/USHC SPECIALIST
WA
Enumeration date
08/14/2006
Last updated
02/15/2012
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