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Contact Information

KIMBERLY A VICKERY, LMP
5060 HIGHWAY 303 NE
SUITE 103
BREMERTON, WA98311
 Phone: 360-377-6335
 Fax: 360-377-6401
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for KIMBERLY A VICKERY · (Female)

NPI # 1174779656
Status Active
Credentials LMP (Licensed Medical Practitioner)
Entity Individual
Enumeration date 08/15/2008
Last updated 10/25/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • WA License # MA00019934
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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