Provider Demographics
NPI:1982853180
Name:KIM, EUNKOOK DANIEL (OD)
Entity Type:Individual
Prefix:DR
First Name:EUNKOOK
Middle Name:DANIEL
Last Name:KIM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 SW 363RD CT
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-7294
Mailing Address - Country:US
Mailing Address - Phone:253-334-4461
Mailing Address - Fax:
Practice Address - Street 1:34520 16TH AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6802
Practice Address - Country:US
Practice Address - Phone:253-835-9162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60035066152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist