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General NPI Number Information
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NPI Number | 1013062983
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Entity Type | Individual
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Provider Name | KIMBROUGH ALLAN BESHEER M.DIV., LMHC, IAAP
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 1ST AVE STE 632
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City | SEATTLE
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State | WA
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Zip | 98104-2231
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Country | US
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Telephone | 206-232-3253
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Fax |
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Provider Business Mailing Address
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Address Line | 14253 SE 14TH ST
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City | BELLEVUE
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State | WA
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Zip | 98007-5522
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Country | US
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Telephone | 425-747-4868
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6767
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License Number State | WA
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