Basic Information
| Provider Information | |||||||||
| NPI: | 1447252507 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HIMEBAUGH | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 34709 9TH AVE S STE B500 | ||||||||
| Address2: | |||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980036789 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539446950 | ||||||||
| FaxNumber: | 2534266344 | ||||||||
| Practice Location | |||||||||
| Address1: | 34709 9TH AVE S STE B500 | ||||||||
| Address2: | |||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980036789 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539446950 | ||||||||
| FaxNumber: | 2534266344 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2005 | ||||||||
| LastUpdateDate: | 04/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | CDR.0000384 | CO | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VX0000X | 19449 | TN | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics | 207V00000X | MD60967563 | WA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 3159742 | 01 | TN | BCBS | OTHER | 1507776 | 05 | TN | MEDICAID | 3818669 | 05 | TN | MEDICAID | 2140731 | 05 | WA | MEDICAID | Q008202 | 05 | TN | MEDICAID |