# FOOT AND ANKLE CENTER OF ISSAQUAH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659758290
- **Authorized official:** DR. STEPHANIE E KIM (OWNER)
- **Authorized official phone:** (425) 947-2880

## Contact information

- **Practice address:** 22510 SE 64TH PL, UNIT 120, ISSAQUAH, WA 98027-5390
- **Practice address phone:** (425) 947-2880
- **Mailing address:** 6947 COAL CREEK PKWY SE, \#753, NEWCASTLE, WA 98059-3136

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO60204241 | WA | Yes |

## Other

- **Enumeration date:** 05/04/2015
- **Last updated:** 12/04/2015