Kimberly Marie Gonzales

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OC60468639 Issued in WA

Practice address

21400 72ND Ave W
Edmonds, WA 98026-7702

Phone

(425) 608-2532

Fax

(425) 771-0116

NPI assigned

May 5, 2014

Last updated

May 5, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1649680125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21400 72ND AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21400 72ND AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267702",
            "telephone_number": "425-608-2532",
            "fax_number": "425-771-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC60468639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amano N Gobena
• Terri Goddard
• Jamila Marten Godfrey, ND
• Emily Gong
• Christopher Michael Gonzales, PHARMD
• Nathan Gonzalez, ATC/L
• Michelle S Goodman, ARNP
• Glenn T Goodwin, PHD
• Gooseberry Speech Therapy LLC
• Dina M Gordon, M.D.

• Occupational Therapy Assistant in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Occupational Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.