Provider Demographics
NPI:1922272665
Name:SEATTLE ENDOCRINOLOGY INC
Entity Type:Organization
Organization Name:SEATTLE ENDOCRINOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOOHEE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-367-5252
Mailing Address - Street 1:1570 N 115TH ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8412
Mailing Address - Country:US
Mailing Address - Phone:206-367-5252
Mailing Address - Fax:206-367-5353
Practice Address - Street 1:1570 N 115TH ST
Practice Address - Street 2:SUITE 10
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8412
Practice Address - Country:US
Practice Address - Phone:206-367-5252
Practice Address - Fax:206-367-5353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037572207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1109545Medicaid
WAGAB11738Medicare PIN
WA1109545Medicaid