Healthcare Provider Details

I. General information

NPI: 1992207484
Provider Name (Legal Business Name): KIMBERLY DELGADO LEMUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3205 S CASCADE ST
KENNEWICK WA
99337-5055
US

IV. Provider business mailing address

660 JADWIN AVE STE K
RICHLAND WA
99352-4241
US

V. Phone/Fax

Practice location:
  • Phone: 509-593-0173
  • Fax:
Mailing address:
  • Phone: 509-593-0173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC61110629
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC61110629
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWI.LW.61561102
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: