MEDICARE: MICHELLE KEMMER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC1500X	Community Health Registered Nurse	60018092	WA

General Provider Information

NPI Number	:	1083135420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE KEMMER

Provider Business Mailing Address
First Line	:	7013 SANDRIDGE RD
Second Line	:
City	:	LONG BEACH
State	:	WA
Zip	:	98631-4703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7013 SANDRIDGE RD
Second Line	:
City	:	LONG BEACH
State	:	WA
Zip	:	98631-4703
Country	:	US
Telephone Number	:	360-642-9349
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2017
Last Update Date	:	07/06/2017

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Directions to “ MICHELLE KEMMER ” Practice Location

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