Individual
MRS. KIMBERLY MARIE IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
815 K ST, HOQUIAM, WA 98550-3705
(360) 537-6430
Mailing address
23 FAIRBAIRN RD, MONTESANO, WA 98563-9740
(360) 581-0559
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AP61371987
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP61371987
WA STATE DOH CREDENTIAL
WA
Enumeration date
10/21/2022
Last updated
10/21/2022
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