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Contact Information

KYONG H KIM, DO
11306 BRIDGEPORT WAY SW
SUITE D
LAKEWOOD, WA98499-3037
 Phone: 253-983-9390
 Fax: 253-983-0066
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for KYONG H KIM · (Male)

NPI Number 1124009303
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 11/07/2005
Last updated 02/15/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • WA License # OP00001595
  • WA Medicaid 1002900
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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