DR. KIMBERLY ANNE WENNER (NPI# 1467442640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467442640 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY ANNE WENNER |
| Credential | MD |
| Practice Address |
5225 Cirque Dr W Ste 200 University Place WA 98467-3639 |
| Mailing Address |
1703 S Meridian Ste 101 Puyallup WA 98371-7590 |
| Practice Telephone | 2538483000 |
| Practice Fax Number | 2538458750 |
| Mailing Telephone | 2538483000 |
| Mailing Fax Number | 2538458750 |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2018-04-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | MD60048557 | WA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11216 Sunrise Blvd E Ste 3-102, Puyallup, WA 983748848 | 2538483000 | 2538458750 |
| 4907 Point Fosdick Dr Nw Ste E700, Gig Harbor, WA 983351842 | 2538483000 | 2538458750 |
| Street Address |
5225 CIRQUE DR W STE 200 |
| City | UNIVERSITY PLACE |
| State | WA |
| Zip Code | 98467-3639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669740924 | Larinda Ogawa | Physician Assistant | 5225 Cirque Dr W Ste 200, University Place, WA 98467-3639 | 2011-12-01 |
| 1215265079 | Leilani R Townsend | Dermatology | 5225 Cirque Dr W Ste 200, University Place, WA 98467-3639 | 2009-12-04 |
| 1548278435 | Robert F Findlay | Dermatology | 5225 Cirque Dr W Ste 200, University Place, WA 98467-3639 | 2006-08-04 |
| 1467460352 | Maureen A Mooney | Dermatology | 5225 Cirque Dr W Ste 200, University Place, WA 98467-3639 | 2006-08-04 |
| 1629041132 | Stephen Conrad Groo | Pathology | 5225 Cirque Dr W Ste 200, University Place, WA 98467-3639 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689218927 | Juliette Gallardo-zamora | Behavioral Analyst | 5915 Orchard St. W, Tacoma, WA 98467 | 2019-10-30 |
| 1306310925 | Nancy Rubi Rosas Rodriguez | Counselor | 5915 Orchard St W., Tacoma, WA 98467 | 2019-01-16 |
| 1801309091 | Penny L Crawford | Registered Nurse | 5424 57th Ave Ct. W., G8, University Place, WA 98467 | 2017-11-09 |
| 1316465578 | C.f. Bridgeport, LLC | Assisted Living Facility | 5250 Bridgeport Way W., University Place, WA 98467 | 2017-09-07 |
| 1265950422 | University Place Rehabilitation Center, LLC | Skilled Nursing Facility | 5520 Bridgeport Way W., University Place, WA 98467 | 2017-09-07 |
| 1689127037 | Rachel Ann Cruz | Counselor | 5915 Orcahrd St W, Tacoma, WA 98467 | 2016-08-02 |
| 1396099313 | Ryan Jack Holbrook | Massage Therapist | 6915 Lakewood Dr W Unit A2, Tacoma, WA 98467 | 2012-10-29 |
| 1740519701 | Laura Jean Hubert | Physical Therapist | 5520 Bridgeport Way, University Place, WA 98467 | 2009-12-21 |
| 1437395548 | Karen Marie Noyes | Occupational Therapy Assistant | 5520 Bridgeport Way West, University Place, WA 98467 | 2008-12-18 |
| 1770751083 | Orchard Medical Clinic | Internal Medicine | 5320 Orchard St W, University Place, WA 98467 | 2008-02-20 |
| Find all providers in zip 98467 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144294240 | Thomas Hirota | Dermatology | 5225 Cirque Dr W, University Place, WA 98467-3604 | 2006-02-15 |
| 1215265079 | Leilani R Townsend | Dermatology | 5225 Cirque Dr W Ste 200, University Place, WA 98467-3639 | 2009-12-04 |
| 1467460352 | Maureen A Mooney | Dermatology | 5225 Cirque Dr W Ste 200, University Place, WA 98467-3639 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629694864 | Fishers Landing Internal Medicine | Dermatology | 1405 Se 164th Ave Ste 101, Vancouver, WA 98683-9644 | 2020-06-23 |
| 1417599374 | Dermatology Solutions | Dermatology | 8503 W Clearwater Ave Ste B, Kennewick, WA 99336-3100 | 2019-10-11 |
| 1588164925 | Northwest Pediatric Dermatology, Pllc | Dermatology | 703 Lilly Rd Ne Ste 105, Olympia, WA 98506-5191 | 2018-02-12 |
| 1255858247 | Ame Phitwong | Dermatology | 21727 76th Ave W Ste H, Edmonds, WA 98026-7549 | 2017-08-29 |
| 1467879320 | Jayasri Iyer | Dermatology | 9924 Ne 185th St Ste 215, Bothell, WA 98011-3504 | 2014-03-27 |
| 1164869459 | Kaley Myer | Dermatology | 304 W Bay Dr Nw Ste 301, Olympia, WA 98502-4957 | 2013-05-28 |
| 1093158305 | Erica Shantha Tarabadkar | Dermatology | 850 Republican Street, Brotman Room 242, Uw Medical Center At Lake Union, Seattle, WA 98109 | 2013-04-17 |
| 1871835322 | Jason Lee Meeker | Dermatology | 2622 S. Meridian, Puyallup, WA 98373-1500 | 2013-03-22 |
| 1578839494 | Carolina Andrea Simunovic | Dermatology | 1959 Ne Pacific St Rm Bb-1353, Box 356524, Seattle, WA 98195-6524 | 2012-03-25 |
| 1184999260 | April Schachtel | Dermatology | 1660 S Columbian Way Va Puget Sound Health Care System, General Internal Medicine Clinic, Seattle, WA 98108 | 2012-03-21 |
| Find all providers with the same taxonomy | ||||
| City | UNIVERSITY PLACE |
| Zip Code | 98467 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.