Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD60565209 | WA |
NPI | 1083939227 |
---|---|
Provider Name | Grace Hyosun Kim |
First Address | Seattle, WA 98112-5211 |
Second Address | Seattle, WA 98112-5211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2010 |
Last Update Date | 29/04/2021 |