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NPI Code Detail

MEDICARE: KIM FARRELL MD

MEDICARE: KIM FARRELL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD00036422WA

General Provider Information

NPI Number : 1306880430
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM FARRELL MD
Provider Business Mailing Address
First Line : 15811 AMBAUM BLVD SW
Second Line : SUITE 170
City : BURIEN
State : WA
Zip : 98166-3066
Country : US
Telephone Number : 206-439-2988
Fax Number : 206-431-3939
Provider Business Practice Location Address
First Line : 10030 SW 210TH ST
Second Line :
City : VASHON
State : WA
Zip : 98070-6584
Country : US
Telephone Number : 206-463-3671
Fax Number : 206-463-3613
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2006
Last Update Date : 11/20/2012

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Directions to “ KIM FARRELL MD” Practice Location

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