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General NPI Number Information
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NPI Number | 1598000515
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Entity Type | Individual
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Provider Name | KIM KATHLEEN WILLIAMS ARNP
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Gender | Female
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Dates
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Enumeration Date | 12/02/2012
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 4800 COLLEGE ST SE
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City | LACEY
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State | WA
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Zip | 98503-4389
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Country | US
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Telephone | 360-413-4250
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Fax | 360-412-2262
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Provider Business Mailing Address
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Address Line | PO BOX 3360
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City | PORTLAND
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State | OR
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Zip | 97208-3360
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | C-APN.0001249-C-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP4688
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | C-APN.0001249-C-NP
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61377599
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License Number State | WA
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