Provider Demographics
NPI:1093946444
Name:KIM, STEPHANIE EUN-HYE (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:EUN-HYE
Last Name:KIM
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:6947 COAL CREEK PKWY SE
Mailing Address - Street 2:#753
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98059-3136
Mailing Address - Country:US
Mailing Address - Phone:425-947-2880
Mailing Address - Fax:800-554-8144
Practice Address - Street 1:13114 120TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3014
Practice Address - Country:US
Practice Address - Phone:425-947-2880
Practice Address - Fax:425-947-2880
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDLL9539213ES0103X
WAPODI.PO.60204241213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery