MEDICARE: KIM MARIE THORBURN 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
1	207R00000X	Internal Medicine Physician	MD00034895	WA
2	2083P0901X	Public Health & General Preventive Medicine Physician	MD00034895	WA

Other Identifiers

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

General Provider Information

NPI Number	:	1720045289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM MARIE THORBURN MD

Provider Business Mailing Address
First Line	:	1101 W COLLEGE AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-2029
Country	:	US
Telephone Number	:	509-324-1660
Fax Number	:	509-324-3609

Provider Business Practice Location Address
First Line	:	1101 W COLLEGE AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-2029
Country	:	US
Telephone Number	:	509-324-1660
Fax Number	:	509-324-3609

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	09/11/2025

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