SOO M KIM NPI 1396271185

NPI Information

NPI: 1396271185
Provider Name: SOO M KIM
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual
Address:
1210 SW 136TH ST
BURIEN, WA
ZIP 98166
Phone: (206) 242-1698
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Soo M Kim is a student in an organized health care education training program in Burien, WA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Soo M Kim NPI is 1396271185. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1210 SW 136TH ST
BURIEN, WA
ZIP 98166-214
Phone: (206) 242-1698

The enumeration date for this NPI number is 5/11/2017 and was last updated on 11/28/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	103K00000X	Behavior Analyst	CG 60553309	WASHINGTON	No
2	390200000X	Student in an Organized Health Care Education/Training Program			No
3	390200000X	Student in an Organized Health Care Education/Training Program		WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	111524501	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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