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:
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366448359 | NPPES |
| Washington | MEDICAID | 8178360 |
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