Provider Demographics
NPI:1154684512
Name:KAWAI, KIMBERLY LINA (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:LINA
Last Name:KAWAI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6727 EVERGREEN WAY
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-4551
Mailing Address - Country:US
Mailing Address - Phone:425-353-7539
Mailing Address - Fax:
Practice Address - Street 1:6727 EVERGREEN WAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-4551
Practice Address - Country:US
Practice Address - Phone:425-353-7539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00020816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist