Doctor Name: | KIMBERLEY DOTSON |
NPI Number: | 1578876462 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA10004367 |
Business Practice Address: | 11919 W. Sprague Ave Airway Heights, WA - 990011899 |
Business Phone Number: | 5092446700 |
Business Fax Number: | 5092446830 |
Mailing Address: | 11919 W Sprague Ave, Po Box 1899 AIRWAY HEIGHTS |
State: | WA |
Postal Code: | 99001 |
Phone Number: | 5092446700 |
Fax Number: | 5092446830 |
NPI Enumeration Date: | 07/20/2010 |
NPI Last Update Date: | 07/20/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA10004367 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |