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General NPI Number Information
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NPI Number | 1598001091
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Entity Type | Organization
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Legal Business Name | KIMBERLY A COY
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Dates
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Enumeration Date | 01/02/2013
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Last Update Date | 01/02/2013
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Provider Practice Location Address
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Address Line | 4020 WHEATON WAY SUITE Q
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City | BREMERTON
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State | WA
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Zip | 98310-3566
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Country | US
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Telephone | 360-373-5883
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Fax | 360-479-5815
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Provider Business Mailing Address
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Address Line | 4020 WHEATON WAY SUITE Q
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City | BREMERTON
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State | WA
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Zip | 98310-3566
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Country | US
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Telephone | 360-373-5883
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Fax | 360-479-5815
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Authorized Official
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Title or Position | OWNER
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Name | MISS KIMBERLY ANNE COY
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Credential | BC-HIS
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Telephone | 360-373-5883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | HA00000742
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | LD00004635
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | HA00000930
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License Number State | WA
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