Provider Demographics
NPI:1174045421
Name:SAIN, KIM
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:SAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18024 N ADDISON CT
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:WA
Mailing Address - Zip Code:99005-8524
Mailing Address - Country:US
Mailing Address - Phone:509-703-9422
Mailing Address - Fax:
Practice Address - Street 1:18024 N ADDISON CT
Practice Address - Street 2:
Practice Address - City:COLBERT
Practice Address - State:WA
Practice Address - Zip Code:99005-8524
Practice Address - Country:US
Practice Address - Phone:509-703-9422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool