Provider Demographics
NPI:1679911960
Name:HOLZKNECHT, KIMBERLY BEESON (DC)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:BEESON
Last Name:HOLZKNECHT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:BEESON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:14700 NE 8TH ST
Mailing Address - Street 2:115
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-4115
Mailing Address - Country:US
Mailing Address - Phone:425-644-8386
Mailing Address - Fax:425-644-2560
Practice Address - Street 1:14700 NE 8TH ST
Practice Address - Street 2:115
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4115
Practice Address - Country:US
Practice Address - Phone:425-644-8386
Practice Address - Fax:425-644-2560
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60305828111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor