Individual
WAYNE W KIM
Active
Individual
WAYNE W KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OP00001562
WA
207QA0401X
Addiction Medicine (Family Medicine) Physician
OP00001562
WA
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
CA
Enumeration date
08/08/2006
Last updated
09/14/2022
Update your record
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