Kim, Kyong Ho

Kim, Kyong Ho is an sole proprietor health care provider with primary practice located at 11306 Bridgeport Way Sw Suite D, Lakewood WA 98499-3037. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Kim, Kyong Ho can be contacted via phone (253) 983-9390.

Contact Information

Primary practice address
11306 Bridgeport Way Sw Suite D Lakewood WA 98499-3037
Phone: (253) 983-9390
Fax: (253) 983-0066
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X OP00001595 Washington
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X OP00001595 Washington

Profile Details

NPI number 1124009303
LBN Legal business name Kim, Kyong Ho
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 7th, 2005
Last updated Feb 15th, 2023 - about 3 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 1124009303 NPPES
Washington MEDICAID 1002900

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