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Individual

TERISA Y KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
6205 200TH ST SW, LYNNWOOD, WA 98036-6053
(425) 775-5052
(425) 775-1838
Mailing address
6205 200TH STREET S.W, LYNNWOOD, WA 98036
(425) 775-5052
(425) 775-1838

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00015156
WA

Other

Enumeration date
05/17/2007
Last updated
07/08/2007
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