Provider Demographics
NPI:1396831376
Name:KIM, WON S (DC)
Entity type:Individual
Prefix:
First Name:WON
Middle Name:S
Last Name:KIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33130 PACIFIC HWY S STE 6
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6440
Mailing Address - Country:US
Mailing Address - Phone:206-335-2730
Mailing Address - Fax:253-661-0030
Practice Address - Street 1:33130 PACIFIC HWY S STE 6
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6440
Practice Address - Country:US
Practice Address - Phone:206-335-2730
Practice Address - Fax:253-661-0030
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH34194111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor