Provider Demographics
NPI:1386853398
Name:KIM, HYO-KYUNG (LAC EAMP)
Entity Type:Individual
Prefix:
First Name:HYO-KYUNG
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:LAC EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31500 33RD PL SW APT P202
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-5922
Mailing Address - Country:US
Mailing Address - Phone:253-326-6877
Mailing Address - Fax:253-322-4687
Practice Address - Street 1:32001 32ND AVE S
Practice Address - Street 2:STE 305
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98001-9601
Practice Address - Country:US
Practice Address - Phone:253-326-6877
Practice Address - Fax:253-322-4687
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2013-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002345171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist