Individual
JEONG H. KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11812 N CREEK PKWY N STE 202, BOTHELL, WA 98011
(425) 287-5500
(425) 287-6440
Mailing address
3814 222ND PL SE, BOTHELL, WA 98021-4220
(425) 922-7401
(425) 899-5304
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00036606
WA
207R00000X
Internal Medicine Physician
MD0036606
WA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
MD00036606
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020945
—
WA
Enumeration date
09/21/2006
Last updated
08/01/2019
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