Provider Demographics
NPI:1467114876
Name:SNYDER, KIM MORRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:MORRIS
Last Name:SNYDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11111 WACHUSETT RD
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98020-6143
Mailing Address - Country:US
Mailing Address - Phone:206-542-1280
Mailing Address - Fax:
Practice Address - Street 1:11111 WACHUSETT RD
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:WA
Practice Address - Zip Code:98020-6143
Practice Address - Country:US
Practice Address - Phone:206-542-1280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00017292207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease