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General NPI Number Information
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NPI Number | 1114372836
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Entity Type | Individual
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Provider Name | KIMBERLY WELLS MD
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Gender | Female
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 317 MARTIN LUTHER KING JR WAY
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City | TACOMA
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State | WA
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Zip | 98405-4234
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Country | US
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Telephone | 253-403-1418
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Fax | 253-403-5955
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Provider Business Mailing Address
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Address Line | PO BOX 5299 MS: 820-5-PCO
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City | TACOMA
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State | WA
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Zip | 98415-0299
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Country | US
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Telephone | 253-459-8231
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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 | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number | 297724
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | MD61274189
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License Number State | WA
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