Individual
MICHAEL B KIMMEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1112 6TH AVE, 200, TACOMA, WA 98405-4040
(253) 272-8664
(253) 404-1352
Mailing address
1112 6TH AVE, 200, TACOMA, WA 98405-4040
(253) 272-8664
(253) 404-1352
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD00018337
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1122KI
REGENCE BLUE SHIELD
—
01
—
203847
LABOR & INDUSTRIES
WA
05
—
8147407
—
WA
Enumeration date
07/11/2006
Last updated
04/15/2008
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