Provider Demographics
NPI:1518182237
Name:ZIMBELMAN, KRISTI L (LMP)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:L
Last Name:ZIMBELMAN
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 1:1409 140TH PL NE # D103
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3963
Mailing Address - Country:US
Mailing Address - Phone:425-922-3919
Mailing Address - Fax:425-449-4612
Practice Address - Street 1:1409 140TH PL NE # D103
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3963
Practice Address - Country:US
Practice Address - Phone:425-922-3919
Practice Address - Fax:425-449-4612
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021630225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist