Provider Demographics
NPI:1447252507
Name:HIMEBAUGH, KAREN S (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:S
Last Name:HIMEBAUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34709 9TH AVE S STE B500
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6789
Mailing Address - Country:US
Mailing Address - Phone:253-944-6950
Mailing Address - Fax:253-426-6344
Practice Address - Street 1:34709 9TH AVE S STE B500
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6789
Practice Address - Country:US
Practice Address - Phone:253-944-6950
Practice Address - Fax:253-426-6344
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV2885207V00000X
COCDR.0000384207V00000X
TN19449207VX0000X
WAMD60967563207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3818669Medicaid
TNT06252BMedicaid
TN3159742OtherBCBS
TN1507776Medicaid
TNQ008202Medicaid
WA2140731Medicaid
TN3818669Medicare ID - Type Unspecified
38186682Medicare PIN