Provider Demographics
NPI:1649786393
Name:KIM, CHRISTOPHER H (PHARM D)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:H
Last Name:KIM
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 NW 57TH ST APT 208
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3479
Mailing Address - Country:US
Mailing Address - Phone:805-794-9100
Mailing Address - Fax:
Practice Address - Street 1:4615 196TH ST SW STE 175
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-3000
Practice Address - Country:US
Practice Address - Phone:425-670-0233
Practice Address - Fax:425-670-0242
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60793723183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist