Provider Demographics
NPI:1023325628
Name:SIMS-BUNDY, KAREN A (RN, CDE)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:SIMS-BUNDY
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2077
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-2077
Mailing Address - Country:US
Mailing Address - Phone:503-413-5089
Mailing Address - Fax:503-413-1860
Practice Address - Street 1:2101 NE 139TH ST
Practice Address - Street 2:SUITE 460
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-2309
Practice Address - Country:US
Practice Address - Phone:360-487-2727
Practice Address - Fax:360-487-2729
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00159846163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPENDINGMedicare PIN