Healthcare Provider Details

I. General information

NPI: 1356208862
Provider Name (Legal Business Name): LINDA KIM ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 S 48TH ST STE 110
TEMPE AZ
85282-1017
US

IV. Provider business mailing address

9005 E KALIL DR
SCOTTSDALE AZ
85260-6835
US

V. Phone/Fax

Practice location:
  • Phone: 480-650-6506
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number97-512
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: