Provider Demographics
NPI:1972995165
Name:SHIN, KYUNG LIM (LAC, DAOM)
Entity Type:Individual
Prefix:
First Name:KYUNG
Middle Name:LIM
Last Name:SHIN
Suffix:
Gender:F
Credentials:LAC, DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18035 14TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-3208
Mailing Address - Country:US
Mailing Address - Phone:206-683-2654
Mailing Address - Fax:
Practice Address - Street 1:18035 14TH AVE NW
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98177-3208
Practice Address - Country:US
Practice Address - Phone:206-683-2654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-24
Last Update Date:2023-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist