Provider Demographics
NPI:1750941217
Name:SHIN, KYUNG SOOK
Entity type:Individual
Prefix:DR
First Name:KYUNG
Middle Name:SOOK
Last Name:SHIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32030 15TH PL SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-5426
Mailing Address - Country:US
Mailing Address - Phone:253-709-0457
Mailing Address - Fax:
Practice Address - Street 1:32030 15TH PL SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-5426
Practice Address - Country:US
Practice Address - Phone:253-709-0457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist