Provider Demographics
NPI:1730279290
Name:KOYAMATSU, KIM ELAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:ELAINE
Last Name:KOYAMATSU
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4519 GRANDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:WA
Mailing Address - Zip Code:98230-9640
Mailing Address - Country:US
Mailing Address - Phone:360-526-3385
Mailing Address - Fax:360-526-4813
Practice Address - Street 1:4519 GRANDVIEW RD
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:WA
Practice Address - Zip Code:98230-9640
Practice Address - Country:US
Practice Address - Phone:360-526-3385
Practice Address - Fax:360-526-4813
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2016-02-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WA367852083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine