Healthcare Provider Details

I. General information

NPI: 1487163887
Provider Name (Legal Business Name): ANDREA KIM SLINKARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2017
Last Update Date: 09/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3740 14TH ST & RAILROAD AVE
JBLM WA
98433
US

IV. Provider business mailing address

1123 WRIGHT RD SE
TENINO WA
98589-9667
US

V. Phone/Fax

Practice location:
  • Phone: 253-967-5271
  • Fax:
Mailing address:
  • Phone: 360-349-1362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: