Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DE00009684 | WA |
NPI | 1003822057 |
---|---|
Provider Name | Dr. Teresa Kim Kang |
First Address | Kirkland, WA 98034-6911 |
Second Address | Kirkland, WA 98034-6926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 07/02/2022 |