Provider Demographics
NPI:1861528424
Name:MEY, KIMBERLY E (MSPT)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:E
Last Name:MEY
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:E
Other - Last Name:VINC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:16250 NE 74TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-7817
Mailing Address - Country:US
Mailing Address - Phone:425-936-1200
Mailing Address - Fax:
Practice Address - Street 1:16250 NE 74TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7817
Practice Address - Country:US
Practice Address - Phone:425-936-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010305225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0078VIOtherREGENCE
WA1861528424OtherDSHS
WA40509UOtherREGENCE BLUESHIELD
WA0078VIOtherREGENCE