| Organization Name: | SPECTRUM CARE, PLLC |
| NPI Number: | 1053798546 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIMBERLY 'KIMMER' VERLYNN COLLISON-RIS (OWNER/PROVIDER) |
| Mailing Address: | 16825 48th Ave W 117 Lynnwood |
| State: | WA US |
| Postal Code: | 980376401 |
| Phone Number: | 4252104187 |
| Fax Number: | 4253611704 |
| NPI Enumeration Date: | 05/04/2015 |
| NPI Last Update Date: | 05/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP30006553 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |