Healthcare Provider Details

I. General information

NPI: 1851998025
Provider Name (Legal Business Name): SAMANTHA A KLIM ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2020
Last Update Date: 10/01/2020
Certification Date: 10/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15650 NE 24TH ST STE A
BELLEVUE WA
98008-2460
US

IV. Provider business mailing address

285 SE ANDREWS ST
ISSAQUAH WA
98027-3417
US

V. Phone/Fax

Practice location:
  • Phone: 425-505-2745
  • Fax:
Mailing address:
  • Phone: 517-881-7483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: