Active NPI
Charles W Kimmel III
- Recovery Care Clinic/Center
- Sedro Woolley, WA
National Provider Identifier
1093623993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recovery Care Clinic/Center
- Practice address
- 1420 Sr 20
Sedro Woolley, WA 98284-1385 - Phone
- (360) 854-7400
- NPI assigned
- Aug 31, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recovery Care Clinic/Center | 261QR0800X | WA | Primary |
Addresses
Primary practice location
1420 Sr 20
Sedro Woolley, WA 98284-1385
Mailing address
1420 Sr 20
Sedro Woolley, WA 98284-1385
Phone (360) 854-7400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788393600000",
"number": "1093623993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 SR 20",
"city": "SEDRO WOOLLEY",
"state": "WA",
"postal_code": "982841385",
"telephone_number": "360-854-7400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 SR 20",
"city": "SEDRO WOOLLEY",
"state": "WA",
"postal_code": "982841385",
"telephone_number": "360-854-7400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMMEL",
"first_name": "CHARLES",
"middle_name": "W",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-08-31",
"last_updated": "2026-09-03",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "261QR0800X",
"taxonomy_group": "",
"desc": "Clinic/Center, Recovery Care",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sedro Woolley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.