Provider Demographics
NPI:1144203043
Name:KIM, JAMES M (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3125 HOWE PL STE 101
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-5634
Mailing Address - Country:US
Mailing Address - Phone:360-647-7750
Mailing Address - Fax:360-647-4290
Practice Address - Street 1:3125 HOWE PL STE 101
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226
Practice Address - Country:US
Practice Address - Phone:360-647-7750
Practice Address - Fax:360-647-4290
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00045399207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8435646Medicaid
WAI04808Medicare UPIN
WAG8861845Medicare PIN