MEDICARE: KIMBERLY KAY SAWYER APRN

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	363LG0600X	Gerontology Nurse Practitioner	AP61441305	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	:	1942080221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY KAY SAWYER APRN

Provider Business Mailing Address
First Line	:	13510 86TH AVENUE CT E
Second Line	:
City	:	PUYALLUP
State	:	WA
Zip	:	98373-6413
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13510 86TH AVENUE CT E
Second Line	:
City	:	PUYALLUP
State	:	WA
Zip	:	98373-6413
Country	:	US
Telephone Number	:	253-241-7701
Fax Number	:

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

Provider Enumeration Date	:	10/03/2023
Last Update Date	:	12/26/2025

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