Individual
JESSIE KIM-DEOBALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1530 N 115TH ST, SUITE 301, SEATTLE, WA 98133-8411
(206) 365-5000
(206) 365-5002
Mailing address
1530 N 115TH ST, SUITE 301, SEATTLE, WA 98133-8411
(206) 365-5000
(206) 365-5002
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093699
—
WA
01
—
5355KI
REGENCE RYDER NUMBER
WA
Enumeration date
09/15/2006
Last updated
07/09/2007
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