Healthcare Provider Details

I. General information

NPI: 1063843563
Provider Name (Legal Business Name): KIMBERLY BLOUNT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2013
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2445 3RD AVE S
SEATTLE WA
98134-1923
US

IV. Provider business mailing address

6224 SYCAMORE AVE NW
SEATTLE WA
98107-2043
US

V. Phone/Fax

Practice location:
  • Phone: 206-252-0000
  • Fax:
Mailing address:
  • Phone: 206-355-1532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT60122081
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: