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NPI Code Detail

MEDICARE: KIMBERLY L ANCHELL PA-C

MEDICARE:   KIMBERLY L ANCHELL  PA-C
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
1363AM0700XMedical Physician AssistantPA157622OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134166911
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY L ANCHELL PA-C
Provider Business Mailing Address
First Line : PO BOX 742997
Second Line :
City : LOS ANGELES
State : CA
Zip : 90074-2997
Country : US
Telephone Number : 360-514-2142
Fax Number : 360-514-6820
Provider Business Practice Location Address
First Line : 475 S COLUMBIA RIVER HWY
Second Line :
City : SAINT HELENS
State : OR
Zip : 97051-2859
Country : US
Telephone Number : 503-397-8040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2006
Last Update Date : 06/30/2022

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Directions to “ KIMBERLY L ANCHELL PA-C” Practice Location

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