Provider Demographics
NPI:1376947275
Name:KUNKLE, KIMBERLY YOUNGS
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:YOUNGS
Last Name:KUNKLE
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 1:2103 S ATLANTIC ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-3615
Mailing Address - Country:US
Mailing Address - Phone:206-329-2050
Mailing Address - Fax:206-726-8564
Practice Address - Street 1:2103 S ATLANTIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-3615
Practice Address - Country:US
Practice Address - Phone:206-329-2050
Practice Address - Fax:206-726-8564
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator