Provider Demographics
NPI:1376907568
Name:KIM, GINA YOUNG (MD, MPH)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:YOUNG
Last Name:KIM
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:YOUNG
Other - Last Name:SHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:325 9TH AVE # 359755
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2499
Practice Address - Country:US
Practice Address - Phone:206-744-9102
Practice Address - Fax:206-744-9976
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60941675207RG0300X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine