Individual
DR. KIM WADSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
405 BLACK HILLS LN SW STE B2, OLYMPIA, WA 98502-8661
(360) 688-1151
Mailing address
PO BOX 13082, OLYMPIA, WA 98508-3082
(360) 688-1151
(360) 282-0738
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OL60864834
WA
207Q00000X
Family Medicine Physician
Primary
OP61075127
WA
Other
Enumeration date
05/31/2018
Last updated
06/03/2022
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