Provider Demographics
NPI:1750333233
Name:KIM, JOE YOUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:YOUNG
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 N 16TH AVE STE D
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-7102
Mailing Address - Country:US
Mailing Address - Phone:509-574-3805
Mailing Address - Fax:509-574-3806
Practice Address - Street 1:1460 N. 16TH AVE., SUITE D
Practice Address - Street 2:WATER'S EDGE
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902
Practice Address - Country:US
Practice Address - Phone:509-574-3805
Practice Address - Fax:509-574-3806
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20625207LP2900X
WAMD6458807207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine