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NPI Code Detail

MEDICARE: GINA SURYUN KIM PHARM D

MEDICARE: GINA SURYUN KIM PHARM D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPH60665585WA

General Provider Information

NPI Number : 1295283570
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA SURYUN KIM PHARM D
Provider Business Mailing Address
First Line : 315 MARTIN LUTHER KING JR WAY
Second Line :
City : TACOMA
State : WA
Zip : 98405-4234
Country : US
Telephone Number : 253-403-3139
Fax Number :
Provider Business Practice Location Address
First Line : 315 MARTIN LUTHER KING JR WAY
Second Line :
City : TACOMA
State : WA
Zip : 98405-4234
Country : US
Telephone Number : 253-403-3139
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2016
Last Update Date : 03/23/2026

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