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General NPI Number Information
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NPI Number | 1902156938
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Entity Type | Individual
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Provider Name | KIMBALL CUTLER AYERS L.M.F.T.A.
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Gender | Male
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 10610 NE 9TH PL UNIT 1007
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City | BELLEVUE
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State | WA
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Zip | 98004-4378
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Country | US
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Telephone | 425-753-9608
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Fax | 425-454-0411
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Provider Business Mailing Address
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Address Line | 10610 NE 9TH PLACE NE UNIT 1007
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City | BELLEVUE
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State | WA
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Zip | 98004
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Country | US
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Telephone | 425-753-9608
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Fax | 425-454-0411
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MG 60261540
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License Number State | WA
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