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1740202514

NPI Code Detail

MEDICARE: KIMBERLEY K HERNER MD

MEDICARE: KIMBERLEY K HERNER 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	207VX0000X	Obstetrics Physician	MD00032100	WA
2	207Q00000X	Family Medicine Physician	MD00032100	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	G8891459	OTHER	WA	MEDICARE - VALLEY MEDICAL GROUP

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	:	1740202514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLEY K HERNER MD

Provider Business Mailing Address
First Line	:	1200 12TH AVE S STE 901
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98144-2712
Country	:	US
Telephone Number	:	206-548-3114
Fax Number	:	206-962-2342

Provider Business Practice Location Address
First Line	:	9245 RAINIER AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-5569
Country	:	US
Telephone Number	:	206-548-5850
Fax Number	:

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/30/2024

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Directions to “ KIMBERLEY K HERNER MD” Practice Location

Language	Start Address	Practice Location

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