Kimbrough, Tyler Graham

Kimbrough, Tyler Graham is an individual health care provider with primary practice located at 21616 76Th Ave W Suite 112, Edmonds WA 98026-7512. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Kimbrough, Tyler Graham can be contacted via phone (425) 775-6651.

Contact Information

Primary practice address
21616 76Th Ave W Suite 112 Edmonds WA 98026-7512
Phone: (425) 775-6651
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X MD60667019 Washington

Profile Details

NPI number 1720121361
LBN Legal business name Kimbrough, Tyler Graham
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2007
Last updated Jul 14th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720121361 NPPES
Washington Other G8882307 MEDICARE NON-KING CO.
Washington Other G8882308 MEDICARE NON-KING CO.

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