Provider Demographics
NPI:1518006329
Name:KIM, HYUN H (DC)
Entity Type:Individual
Prefix:DR
First Name:HYUN
Middle Name:H
Last Name:KIM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6720 WATERTON CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275
Mailing Address - Country:US
Mailing Address - Phone:425-771-2225
Mailing Address - Fax:425-670-8121
Practice Address - Street 1:6720 WATERTON CIRLCE
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275
Practice Address - Country:US
Practice Address - Phone:425-771-2225
Practice Address - Fax:425-670-8121
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034052111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8875163Medicare PIN