Healthcare Provider Details

I. General information

NPI: 1467460675
Provider Name (Legal Business Name): KIMBERLY G SALES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY G TROY-SALES ARNP

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 AHTANUM RIDGE DR
UNION GAP WA
98903-1839
US

IV. Provider business mailing address

PO BOX 719
SUNNYSIDE WA
98944-0719
US

V. Phone/Fax

Practice location:
  • Phone: 509-454-7700
  • Fax: 509-454-7710
Mailing address:
  • Phone: 509-837-1617
  • Fax: 509-837-4908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP.AP.30002429-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: