Individual
KIMBERLY KAY GOMERSALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
22845 NE CEDAR PARK CRES, REDMOND, WA 98053-5887
(808) 561-2320
Mailing address
22845 N.E. CEDAR PARK CRESCENT, REDMOND, WA 98053
(808) 561-2320
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60228375
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LL60228375
—
WA
Enumeration date
10/30/2012
Last updated
10/30/2012
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