Kimberlee Mae Crosby
Individual provider Active NPI Contractor · Longview, WA
NPI 1154790046 · NPPES record last updated Sep 21, 2015
Key facts
- NPI
- 1154790046
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- IHS.FS.60432843 (WA)
- Practice address
- 1157 3Rd Ave Ste 218
Longview, WA 98632-6005 - Phone
- (360) 952-3100
- Fax
- (360) 952-3098
- NPI assigned
- Sep 21, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IHS.FS.60432843 | WA | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | IHS.FS.60432843 | WA | Yes |
Addresses
Primary practice location
1157 3Rd Ave Ste 218
Longview, WA 98632-6005
Mailing address
1157 3Rd Ave Ste 218
Longview, WA 98632-6005
Phone (360) 952-3100
Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.