Healthcare Provider Details

I. General information

NPI: 1043180565
Provider Name (Legal Business Name): SKY KILI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 214TH ST SE STE 110
BOTHELL WA
98021-4412
US

IV. Provider business mailing address

3150 FAIRVIEW AVE E APT 215
SEATTLE WA
98102-1300
US

V. Phone/Fax

Practice location:
  • Phone: 425-488-4974
  • Fax: 425-892-7872
Mailing address:
  • Phone: 215-595-3033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: