Healthcare Provider Details

I. General information

NPI: 1114610284
Provider Name (Legal Business Name): KIMBERLY V JIMENEZ GARAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 06/02/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 150TH AVE SE
BELLEVUE WA
98006-1668
US

IV. Provider business mailing address

KIMBERLYJIMENEGARAY@SEAMARCHC.ORG 3801 150TH AVE SE
BELLEVUE WA
98007
US

V. Phone/Fax

Practice location:
  • Phone: 425-460-7114
  • Fax: 425-460-7115
Mailing address:
  • Phone: 425-460-7114
  • Fax: 425-460-7115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: