Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD60101869 | WA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | MD60101869 | WA |
NPI | 1336125798 |
---|---|
Provider Name | Dr. Namou Kim |
First Address | Salt Lake City, UT 84125-0608 |
Second Address | Seattle, WA 98104-1342 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2005 |
Last Update Date | 16/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1336125798 | (05) | WA |
298197 | DEPT OF LABOR & INDUSTRIES (01) | WA |
8550915 | (05) | WA |
H83901 | (02) |