Individual
MS. MARYDINA KIRKBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
16126 NE 3RD PL, BELLEVUE, WA 98008-4433
(425) 417-7477
Mailing address
15600 NE 8TH ST. B1#216, BELLEVUE, WA 98008-3927
(425) 417-7477
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00116530
WA
363L00000X
Nurse Practitioner
AP30005811
WA
363LF0000X
Family Nurse Practitioner
AP30005811
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0161864
L&I PIN
WA
01
—
16088U
REGENCE BLUE SHIELD PIN
WA
05
—
9633983
—
WA
Enumeration date
06/21/2006
Last updated
04/19/2016
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