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General NPI Number Information
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NPI Number | 1982853180
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Entity Type | Individual
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Provider Name | EUNKOOK DANIEL KIM O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | 34520 16TH AVE S
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City | FEDERAL WAY
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State | WA
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Zip | 98003-6802
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Country | US
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Telephone | 253-835-9162
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Fax |
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Provider Business Mailing Address
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Address Line | 703 SW 363RD CT
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City | FEDERAL WAY
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State | WA
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Zip | 98023-7294
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Country | US
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Telephone | 253-334-4461
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD60035066
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License Number State | WA
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