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NPI Code Detail

MEDICARE: HYUN JI KIM

MEDICARE: HYUN JI KIM
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
1367500000XCertified Registered Nurse AnesthetistAP61564724WA

General Provider Information

NPI Number : 1780454611
Entity Type Code : Individual
Provider Name (Legal Business Name) : HYUN JI KIM
Provider Business Mailing Address
First Line : 400 E PIONEER STE 101
Second Line :
City : PUYALLUP
State : WA
Zip : 98372-3256
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1615 DELAWARE ST
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-2367
Country : US
Telephone Number : 360-414-2000
Fax Number : 360-414-7638
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2024
Last Update Date : 06/16/2026

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Directions to “ HYUN JI KIM ” Practice Location

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