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General NPI Number Information
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NPI Number | 1881521797
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Entity Type | Individual
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Provider Name | AGNES RAN KIM
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Gender | Female
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 19191 N KELSEY ST
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City | MONROE
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State | WA
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Zip | 98272-1459
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Country | US
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Telephone | 360-365-4036
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Fax |
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Provider Business Mailing Address
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Address Line | 1118 7TH AVE NW
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City | ISSAQUAH
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State | WA
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Zip | 98027-2749
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHRM.PH.61580904
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License Number State | WA
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