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General NPI Number Information
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NPI Number | 1306010350
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Entity Type | Organization
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Legal Business Name | SOON H. KIMM, M.D., P.C.
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Dates
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Enumeration Date | 04/21/2008
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Last Update Date | 04/21/2008
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Provider Practice Location Address
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Address Line | 1207 N 200TH ST SUITE 215
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City | SHORELINE
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State | WA
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Zip | 98133-3213
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Country | US
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Telephone | 206-542-7606
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Fax | 206-533-9880
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Provider Business Mailing Address
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Address Line | 1207 N 200TH ST SUITE 215
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City | SHORELINE
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State | WA
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Zip | 98133-3213
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Country | US
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Telephone | 206-542-7606
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Fax | 206-533-9880
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Authorized Official
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Title or Position | PRESIDENT
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Name | SOON H KIMM
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Credential | M.D.
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Telephone | 206-542-7606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MD00022272
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License Number State | WA
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