Provider Demographics
NPI:1891897468
Name:KING, STEPHEN HAIM (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:HAIM
Last Name:KING
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 1:34612 6TH AVE S STE 110
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8723
Mailing Address - Country:US
Mailing Address - Phone:253-927-1882
Mailing Address - Fax:
Practice Address - Street 1:34612 6TH AVE S STE 110
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8723
Practice Address - Country:US
Practice Address - Phone:253-927-1882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML20007349208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology