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NPI Code Detail

MEDICARE: KIMBERLY J MCDERMOTT MD

MEDICARE: KIMBERLY J MCDERMOTT MD
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
1207Q00000XFamily Medicine PhysicianMD00031795WA
2208000000XPediatrics PhysicianMD00031795WA

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 : 1437159209
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY J MCDERMOTT MD
Provider Business Mailing Address
First Line : 955 POWELL AVE SW
Second Line :
City : RENTON
State : WA
Zip : 98057-2908
Country : US
Telephone Number : 425-277-1311
Fax Number : 425-277-1566
Provider Business Practice Location Address
First Line : 16200 116TH AVE SE
Second Line :
City : RENTON
State : WA
Zip : 98058-5200
Country : US
Telephone Number : 425-400-1899
Fax Number : 425-663-8000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2005
Last Update Date : 01/23/2025

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Directions to “ KIMBERLY J MCDERMOTT MD” Practice Location

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