Kimura, Irene Kimivo

Kimura, Irene Kimivo is an individual health care provider with primary practice located at 821 E Broadway Ave Suite 1, Moses Lake WA 98837-5934. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Kimura, Irene Kimivo can be contacted via phone (509) 765-1602.

Contact Information

Primary practice address
821 E Broadway Ave Suite 1 Moses Lake WA 98837-5934
Phone: (509) 765-1602
Fax: (509) 766-9778
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD00032544 Washington

Profile Details

NPI number 1366448359
LBN Legal business name Kimura, Irene Kimivo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Dec 18th, 2013 - about 13 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 1366448359 NPPES
Washington MEDICAID 8178360

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