Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DE 60147287 | WA |
N | 1223D0004X | Dentist Anesthesiologist | GA60178267 | WA |
NPI | 1871893008 |
---|---|
Provider Name | Dr. Hanna S Kim |
First Address | Seattle, WA 98144-2847 |
Second Address | Seattle, WA 98144-2847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2010 |
Last Update Date | 03/01/2014 |