Basic Information
| Provider Information | |||||||||
| NPI: | 1790015766 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAHIRIMBANYI | ||||||||
| FirstName: | PERESI | ||||||||
| MiddleName: | KAMAZOOB | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 520 N 4TH AVE STE 1000 | ||||||||
| Address2: | |||||||||
| City: | PASCO | ||||||||
| State: | WA | ||||||||
| PostalCode: | 993015257 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094168849 | ||||||||
| FaxNumber: | 5095423059 | ||||||||
| Practice Location | |||||||||
| Address1: | 7425 WRIGLEY DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | PASCO | ||||||||
| State: | WA | ||||||||
| PostalCode: | 993015292 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094168888 | ||||||||
| FaxNumber: | 5095456842 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2010 | ||||||||
| LastUpdateDate: | 07/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 25754 | OK | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MD 60193720 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.