Individual
MICHAEL CHUNGUCK KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 MAIN STREET, VANCOUVER, WA 98663
(360) 696-4691
(360) 823-2260
Mailing address
PO BOX 61896, VANCOUVER, WA 98666-1896
(360) 823-2012
(360) 823-2260
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD00038580
WA
207W00000X
Ophthalmology Physician
MD22633
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8255838
—
WA
Enumeration date
03/01/2006
Last updated
01/02/2019
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