Kim, Soo M

Kim, Soo M is an sole proprietor health care provider with primary practice located at 1210 Sw 136Th St , Burien WA 98166-1214. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is her primary health care specialty. Kim, Soo M can be contacted via phone (206) 242-1698.

Contact Information

Primary practice address
1210 Sw 136Th St Burien WA 98166-1214
Phone: (206) 242-1698
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X CG 60553309 Washington
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X Washington

Profile Details

NPI number 1396271185
LBN Legal business name Kim, Soo M
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 11th, 2017
Last updated Nov 28th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396271185 NPPES
Washington MEDICAID 111524501

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