NPI 1124889126

Kimmeth Jack Irwin

Practitioner Peer Specialist Pasco, WA

Practice location

Address: 1906 N 20th Ave, Pasco, WA 99301-3393
Phone: (509) 502-1715

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X

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Registry record

NPI: 1124889126
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Jan 2024
Record last updated: 17 Jan 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.