Provider Demographics
NPI:1902533433
Name:KIM, NAMJOONG
Entity Type:Individual
Prefix:
First Name:NAMJOONG
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9714 3RD AVE NE STE 201
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2000
Mailing Address - Country:US
Mailing Address - Phone:808-636-7077
Mailing Address - Fax:206-707-7633
Practice Address - Street 1:9714 3RD AVE NE STE 201
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2000
Practice Address - Country:US
Practice Address - Phone:808-636-7077
Practice Address - Fax:206-707-7633
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61313084111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor