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Kali Marie Thibault

NPI Registration Record

Provider / OrganizationNPIDate Certified
KALI MARIE THIBAULT13367584322020-12-18

Kali Marie Thibault [F] graduated in 2020 and primarily specializes in Physician Assistant.

Kali Marie Thibault is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1336758432. Registration indicates Kali Marie Thibault is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)

PECOS ID3971929886
RegistrationPART-B:Y
DME:Y
HHA:Y
PMD:Y
Entity TypeIndividual
Provider Name Kali Marie Thibault PHYSICIAN ASSISTANT
Practice Office Address11311 BRIDGEPORT WAY SW STE 309
LAKEWOOD, WA US
Practice Office Telephone2539852949
Practice Office Fax2539852948
Mailing Address11311 BRIDGEPORT WAY SW STE 309
LAKEWOOD, WA 984993078 US
Business Telephone2539852949
Business Fax2539852948
Contact Endpoints
Direct Messaging Address [][email protected]Direct Franciscan Medical Group
HPT Codes
CodePractice
License No
State
363A00000X PRIMARYAccess to Adult/Geriatric Primary Care Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician AssistantAccess to Pediatric Primary Care Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers
Physician Assistant
All Other Specialties & Provider Types

Physician Assistant
Physician Assistants & Advanced Practice Nursing Providers
PA61073932
WA
OPI Codes
2165926 MEDICAID WA
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