Individual
KIMBERLY VAN DALSEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPCT
Contact information
Practice address
700 LILLY RD NE, OLYMPIA, WA 98506-5115
(360) 923-7000
Mailing address
PO BOX 34584, SEATTLE, WA 98124-1584
(509) 241-7349
(509) 241-7628
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00004120
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8233215
—
WA
Enumeration date
02/07/2007
Last updated
06/22/2021
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