Provider Demographics
NPI:1518708122
Name:KIMORI, HARRIET MORAA (ARNP)
Entity type:Individual
Prefix:
First Name:HARRIET
Middle Name:MORAA
Last Name:KIMORI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10193 35TH PL NE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-6500
Mailing Address - Country:US
Mailing Address - Phone:360-672-0185
Mailing Address - Fax:
Practice Address - Street 1:10193 35TH PL NE
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-6500
Practice Address - Country:US
Practice Address - Phone:360-672-0185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61524274363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care