Provider Demographics
NPI:1235203498
Name:KUZARA, KIMBERLY EILEEN (LMP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:EILEEN
Last Name:KUZARA
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1753 NW 56TH ST
Mailing Address - Street 2:#4
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-5223
Mailing Address - Country:US
Mailing Address - Phone:206-920-1341
Mailing Address - Fax:
Practice Address - Street 1:4630 200TH ST SW
Practice Address - Street 2:STE.D
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6608
Practice Address - Country:US
Practice Address - Phone:425-778-2325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019005225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist