Individual
KYEONG SUK KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, TACOMA, WA 98431-1100
(253) 968-1110
Mailing address
1208 CARSON LN SE APT C105, LACEY, WA 98503-1363
(731) 514-7406
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
171277
TN
163WC0400X
Case Management Registered Nurse
Primary
171277
TN
Other
Enumeration date
04/04/2016
Last updated
07/25/2019
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