Kingston Liberty Bay Internal Medicine

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

PA10000878 Issued in WA

Legal business name

KINGSTON LIBERTY BAY INTERNAL MEDICINE

Practice address

25995 Barber Cut Off Rd NE
Kingston, WA 98346-8456

Phone

(360) 297-6900

Fax

(360) 297-2034

NPI assigned

Jan 22, 2010

Last updated

Jan 22, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debra Buechler

Title

Office Administrator

Phone

(360) 297-6900

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264118400000",
    "number": "1700117264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25995 BARBER CUT OFF RD NE",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "983468456",
            "telephone_number": "360-297-6900",
            "fax_number": "360-297-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25995 BARBER CUT OFF RD NE",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "983468456",
            "telephone_number": "360-297-6900",
            "fax_number": "360-297-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSTON LIBERTY BAY INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A",
        "authorized_official_last_name": "BUECHLER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "360-297-6900"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "PA10000878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Kelton, M. ED
• Ki S Kim, L, AC.
• Joshua Evan Kingsbury, LMP
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• Samantha Christine Kottke, L.M.P.
• Molly Kraft, MA CCC-SLP
• Susan Krall

• Internal Medicine Physician in Kingston, WA
• Providers in Kingston, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.