Individual
KIM LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2930 MAPLE ST, EVERETT, WA 98201-3832
(425) 261-1692
Mailing address
2930 MAPLE ST, EVERETT, WA 98201-3832
(425) 261-1692
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A7092
CA
207R00000X
Internal Medicine Physician
Primary
OP00001825
WA
Other
Enumeration date
09/11/2007
Last updated
04/27/2021
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