| Soon H. Kimm, M.d., P.c. | |
|
1207 N 200th St Suite 215 Shoreline WA 98133-3213 | |
| (206) 542-7606 | |
| (206) 533-9880 |
| Full Name | Soon H. Kimm, M.d., P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1207 N 200th St, Shoreline, Washington |
| Authorized Official Name and Position | Soon H Kimm (PRESIDENT) |
| Authorized Official Contact | 2065427606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soon H. Kimm, M.d., P.c. 1207 N 200th St Suite 215 Shoreline WA 98133-3213 Ph: (206) 542-7606 | Soon H. Kimm, M.d., P.c. 1207 N 200th St Suite 215 Shoreline WA 98133-3213 Ph: (206) 542-7606 |
| NPI Number | 1306010350 |
|---|---|
| Provider Enumeration Date | 04/21/2008 |
| Last Update Date | 04/21/2008 |
| Medicare PECOS PAC ID | 0749355618 |
|---|---|
| Medicare Enrollment ID | O20080813000064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306010350 | NPI | - | NPPES |
| 1112747 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD00022272 (Washington) | Primary |
| Provider Name | Soon H Kimm |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912985169 PECOS PAC ID: 4284718206 Enrollment ID: I20080228000393 |
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