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General NPI Number Information
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NPI Number | 1811574858
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Entity Type | Individual
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Provider Name | JI HUN KIM DO
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Gender | Male
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Dates
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Enumeration Date | 03/25/2021
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 11695 NE 4TH ST
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City | BELLEVUE
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State | WA
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Zip | 98004-5268
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Country | US
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Telephone | 425-637-1855
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Fax | 425-344-7970
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Provider Business Mailing Address
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Address Line | PO BOX 741515
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City | LOS ANGELES
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State | CA
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Zip | 90074-1515
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OP61548442
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License Number State | WA
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