Provider Demographics
NPI:1831226505
Name:KIM, THOMAS (DC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
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 1:13256 NE 20TH ST
Mailing Address - Street 2:SUITE 17
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2021
Mailing Address - Country:US
Mailing Address - Phone:425-649-2181
Mailing Address - Fax:425-649-2170
Practice Address - Street 1:13256 NE 20TH ST
Practice Address - Street 2:SUITE 17
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2021
Practice Address - Country:US
Practice Address - Phone:425-649-2181
Practice Address - Fax:425-649-2170
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3412111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor