KIMBERLY SUE WILLIAMS FNP NPI 1578870069

NPI Information

NPI: 1578870069
Provider Name: KIMBERLY SUE WILLIAMS, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
18040 SW LOWER BOONES FERRY RD
SUITE 100
TIGARD, OR
ZIP 97224
Phone: (503) 216-0700
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Kimberly Sue Williams, FNP is a family nurse practitioner in Tigard, OR with 14 years of experience. Kimberly Sue Williams, FNP NPI is 1578870069. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

18040 SW LOWER BOONES FERRY RD
SUITE 100
TIGARD, OR
ZIP 97224-258
Phone: (503) 216-0700
Fax: (503) 216-0750

The NPI 1578870069 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/7/2010 and was last updated on 3/25/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207V00000X	Obstetrics & Gynecology		NP19924	CALIFORNIA	No
2	208000000X	Pediatrics		NP19924	CALIFORNIA	No
3	363L00000X	Nurse Practitioner		NP19924	CALIFORNIA	No
4	363LF0000X	Nurse Practitioner	Family	201393029NP-PP	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	500667975	MEDICAID	OREGON
2	P01404411	OTHER	OREGON	RR MEDICARE - PH&S
3	NP19924	OTHER	CALIFORNIA	CA. BOARD OF NURSING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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