Kim, Mark S.
Kim, Mark S. is an sole proprietor health care provider with primary practice located at 1803 S Meridian , Puyallup WA 98371. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Phlebology. Allopathic & Osteopathic Physicians / Phlebology is his primary health care specialty. Kim, Mark S. can be contacted via phone (253) 268-3400.Contact Information
Primary practice address
1803 S Meridian
Puyallup WA 98371
Phone: (253) 268-3400
Fax: (253) 268-3870
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD00038816 | Washington |
| Allopathic & Osteopathic Physicians / Phlebology | 202K00000X | MD00038816 | Washington |
Profile Details
| NPI number | 1053403634 |
|---|---|
| LBN Legal business name | Kim, Mark S. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 29th, 2006 |
| Last updated | Jan 15th, 2019 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053403634 | NPPES |
| Washington | MEDICAID | 8255697 |
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