Individual
KIM EVANGELINE FUNDERBURK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
401 W MAIN ST, STE B, WALLA WALLA, WA 99362-2837
(509) 240-2644
(509) 524-0260
Mailing address
PO BOX 2644, WALLA WALLA, WA 99362-0333
(509) 240-2644
(509) 524-0260
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60020675
WA
Other
Enumeration date
03/30/2007
Last updated
06/02/2014
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