Provider Demographics
NPI:1457716292
Name:KIM, NATALIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14935 NE 87TH ST
Mailing Address - Street 2:SUITE #101
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-2046
Mailing Address - Country:US
Mailing Address - Phone:425-883-3525
Mailing Address - Fax:425-881-8779
Practice Address - Street 1:14935 NE 87TH ST
Practice Address - Street 2:SUITE #101
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-2046
Practice Address - Country:US
Practice Address - Phone:425-883-3525
Practice Address - Fax:425-881-8779
Is Sole Proprietor?:No
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00040583183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPH00040583OtherPHARMACIST