Healthcare Provider Details

I. General information

NPI: 1023245644
Provider Name (Legal Business Name): KIM RICHARDS DRIFTMIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2009
Last Update Date: 11/08/2020
Certification Date: 11/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE N
SEATTLE WA
98109-5122
US

IV. Provider business mailing address

3745 GEIST RD
FAIRBANKS AK
99709-3554
US

V. Phone/Fax

Practice location:
  • Phone: 206-520-5000
  • Fax:
Mailing address:
  • Phone: 907-456-3338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD60931365
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberMD60931365
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: