Healthcare Provider Details

I. General information

NPI: 1508937509
Provider Name (Legal Business Name): KIMBERLY A. KRABILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 MADISON ST STE 860
SEATTLE WA
98104-3539
US

IV. Provider business mailing address

1229 MADISON ST STE 860
SEATTLE WA
98104-3539
US

V. Phone/Fax

Practice location:
  • Phone: 206-223-2178
  • Fax: 253-396-4870
Mailing address:
  • Phone: 206-223-2178
  • Fax: 253-396-4870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD00037548
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberMD00037548
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: