Provider Demographics
NPI:1588007074
Name:DEUSER, KIMBERLEE SHANNON (BSW)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLEE
Middle Name:SHANNON
Last Name:DEUSER
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 N LACEY ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-5331
Mailing Address - Country:US
Mailing Address - Phone:509-216-0632
Mailing Address - Fax:509-778-4711
Practice Address - Street 1:59 E QUEEN AVE STE 111
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1400
Practice Address - Country:US
Practice Address - Phone:509-413-8253
Practice Address - Fax:509-778-4711
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator