Individual
DR. DOUG SHIN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
31830 PACIFIC HWY S STE D, FEDERAL WAY, WA 98003-5449
(253) 941-7100
(253) 941-1510
Mailing address
31830 PACIFIC HWY S STE D, FEDERAL WAY, WA 98003-5449
(253) 941-7100
(253) 941-1510
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00027275
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1302280
—
WA
01
—
78257
LABOR AND INDUSTRIES ID
WA
01
—
911891770
TAX IDENTIFICATION NUMBER
WA
01
—
KI2297
REGENCE PROVIDER ID #
WA
Enumeration date
07/19/2005
Last updated
02/13/2025
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