Provider Demographics
NPI:1750105532
Name:KILBY, PAMELA ANNE
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANNE
Last Name:KILBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12207 198TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98077-5650
Mailing Address - Country:US
Mailing Address - Phone:425-283-8346
Mailing Address - Fax:
Practice Address - Street 1:12207 198TH AVE NE
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98077-5650
Practice Address - Country:US
Practice Address - Phone:425-283-8346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver