Healthcare Provider Details

I. General information

NPI: 1710743075
Provider Name (Legal Business Name): TK HEALTH & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12721 NE BEL RED RD STE 130
BELLEVUE WA
98005-2653
US

IV. Provider business mailing address

5830 119TH ST SE
SNOHOMISH WA
98296-6967
US

V. Phone/Fax

Practice location:
  • Phone: 425-484-2548
  • Fax:
Mailing address:
  • Phone: 425-770-1888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. TAE HO KIM
Title or Position: DOCTOR OF ACUPUNCTURE
Credential: DAC, EAMP
Phone: 425-770-1888