Provider Demographics
NPI:1881080349
Name:HANSEN, KIMBERLY ROBIN SCHMALFUSS (ND)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ROBIN SCHMALFUSS
Last Name:HANSEN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7340 NE 142ND PL
Mailing Address - Street 2:APT B
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-4953
Mailing Address - Country:US
Mailing Address - Phone:410-353-9700
Mailing Address - Fax:
Practice Address - Street 1:7340 NE 142ND PL
Practice Address - Street 2:APT B
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4953
Practice Address - Country:US
Practice Address - Phone:410-353-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-11
Last Update Date:2015-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT 60511430175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath