Individual
JESSICA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-3186
(253) 968-1110
Mailing address
PO BOX 11782, NEWPORT BEACH, CA 92658-5041
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
21602
CA
363LW0102X
Women's Health Nurse Practitioner
Primary
21602
CA
Other
Enumeration date
04/12/2012
Last updated
09/01/2020
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