Provider Demographics
NPI:1457408064
Name:KIM, STEVE HOONSANG (MD)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:HOONSANG
Last Name:KIM
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 1:22232 17TH AVE SE STE 308
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-7425
Mailing Address - Country:US
Mailing Address - Phone:425-296-3837
Mailing Address - Fax:206-215-3870
Practice Address - Street 1:1750 112TH AVE NE
Practice Address - Street 2:SUITE D050
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3752
Practice Address - Country:US
Practice Address - Phone:206-215-3850
Practice Address - Fax:206-215-3870
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042157207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4385KIOtherREGENCE INSURANCE NUM
WA8349011Medicaid
WA8934826OtherDEPT OF LABOR AND INDUSTR
WA7843KIOtherREGENCE INSURANCE NUM
WA3732KIOtherREGENCE INSURANCE NUM
WA8438KIOtherREGENCE INSURANCE NUM
WA8934826OtherDEPT OF LABOR AND INDUSTR
WA8438KIOtherREGENCE INSURANCE NUM
WA8803195Medicare ID - Type UnspecifiedMEDICARE NUMBER