Healthcare Provider Details

I. General information

NPI: 1013820513
Provider Name (Legal Business Name): KIMBERLY DICKENSON ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 872816
VANCOUVER WA
98687-2816
US

IV. Provider business mailing address

PO BOX 872816
VANCOUVER WA
98687-2816
US

V. Phone/Fax

Practice location:
  • Phone: 360-609-1795
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: