Individual
KIMBERLY JEAN FUSARO WARTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4201 RUCKER AVE, EVERETT, WA 98203-2215
(425) 382-4000
Mailing address
4201 RUCKER AVE, EVERETT, WA 98203-2215
(425) 382-4000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA61018533
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
PA61018533
WA
Other
Enumeration date
01/11/2018
Last updated
06/27/2025
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