Individual
KIMBERLY GRAY MAHEALANI WING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6022 MINER DR SW, TUMWATER, WA 98512-1601
(808) 628-0908
Mailing address
6022 MINER DR SW, TUMWATER, WA 98512-1601
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60816395
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000
DO NOT HAVE NUMBERS
—
Enumeration date
09/23/2019
Last updated
09/23/2019
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