MEDICARE: KATHY KIM OD & ASSOCIATES, PLLC

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
1	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902850308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATHY KIM OD & ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	8520 STEILACOOM BLVD SW STE 200A
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98498-4773
Country	:	US
Telephone Number	:	253-475-3937
Fax Number	:	855-664-7324

Provider Business Practice Location Address
First Line	:	8520 STEILACOOM BLVD SW
Second Line	:	SUITE 101
City	:	LAKEWOOD
State	:	WA
Zip	:	98498-4773
Country	:	US
Telephone Number	:	253-475-3937
Fax Number	:	855-664-7324

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	KATHY KIM
Credential	:	OD
Telephone Number	:	253-475-3937

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	04/21/2025

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