Provider Demographics
NPI:1720044647
Name:KIM, JOOHEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOOHEE
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1130 N 185TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4011
Mailing Address - Country:US
Mailing Address - Phone:205-542-1000
Mailing Address - Fax:206-542-5353
Practice Address - Street 1:1130 N 185TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-4011
Practice Address - Country:US
Practice Address - Phone:205-542-1000
Practice Address - Fax:206-542-5353
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037572207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1109545Medicaid
WAAB11738Medicare ID - Type UnspecifiedKING COUNTY
WA1109545Medicaid
WA8806145Medicare ID - Type UnspecifiedSNOHOMISH COUNTY