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General NPI Number Information
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NPI Number | 1184917650
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Entity Type | Individual
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Provider Name | JILL CLAIRE KINNEY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/17/2011
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Last Update Date | 05/17/2011
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Provider Practice Location Address
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Address Line | 20 N TACOMA AVE STE B OFFICE #3
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City | TACOMA
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State | WA
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Zip | 98403-3133
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Country | US
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Telephone | 206-849-3645
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 TOWN CENTER SUITE 180 #19
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City | TACOMA
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State | WA
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Zip | 98422-1193
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Country | US
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Telephone | 206-849-3645
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Fax | 253-517-8142
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY00000337
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License Number State | WA
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