Individual
CHARLENE KIMBALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
9501 STATE AVE, MARYSVILLE, WA 98270-2235
(425) 308-2933
Mailing address
29007 2ND AVE NW, ARLINGTON, WA 98223-9135
(425) 308-2933
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA00009115
WA
Other
Enumeration date
02/01/2009
Last updated
02/01/2009
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