MARK S. KIM (NPI# 1053403634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053403634 |
| Entity Type | Individual |
| Full Name | MARK S. KIM |
| Credential | MD |
| Practice Address |
1803 S Meridian Puyallup WA 98371 |
| Mailing Address |
1803 S Meridian Puyallup WA 98371-7513 |
| Practice Telephone | 2532683400 |
| Practice Fax Number | 2532683870 |
| Mailing Telephone | 2535896573 |
| Mailing Fax Number | 2539841079 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2019-01-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | MD00038816 | WA | Allopathic & Osteopathic Physicians |
| Y | 202K00000X | Phlebology | MD00038816 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8255697 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4901 108th St Sw, Lakewood, WA 984993724 | 2535896573 | 2539841079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881125672 | Mark Honest Kim | Student in an Organized Health Care Education/Training Program | 1468 Madison Ave Fl 8, New York, NY 10029 | 2017-03-23 |
| 1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
| 1043306970 | Mark Kim | Dentist | 24422 Hawthorne Blvd, Suite A, Torrance, CA 90505-6581 | 2006-10-05 |
| 1578597282 | Mark M Kim | Internal Medicine | 7927 Ritchie Hwy., Glen Burnie, MD 21061 | 2006-07-10 |
| 1487633228 | Mark Y Kim | Internal Medicine | 3900 N Buffalo Road, Orchard Park, NY 14127-1842 | 2006-01-11 |
| 1083136279 | Mark Joong-pyoung Kim | Physical Therapist | 200 E Del Mar Blvd Ste 112, Pasadena, CA 91105-2552 | 2017-07-10 |
| 1003198458 | Mark Y Kim | Pharmacist | 510 N Alamo Rd, Alamo, TX 78516-2306 | 2011-09-12 |
| 1649580002 | Mark Kim | Counselor | 1600 W Eau Gallie Blvd, Suite 201u, Melbourne, FL 32935-4149 | 2010-10-19 |
| 1073743621 | Mark Sung-kyoung Kim | Internal Medicine | 11539 Hawthorne Blvd, 6e, Hawthorne, CA 90250-2381 | 2009-07-16 |
| 1548402894 | Mark Sejun Kim | Anesthesiology | 111 S 11th St, Suite 8490, Philadelphia, PA 19107-4824 | 2009-04-01 |
| Street Address |
1803 S MERIDIAN |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922510726 | Jessica Armitage | Nurse Practitioner | 1803 S Meridian, Puyallup, WA 98371-7513 | 2017-11-02 |
| 1366785685 | Eterna Vein & Medical Aesthetics, Pllc | Surgery | 1803 S Meridian, Puyallup, WA 98371-7513 | 2013-04-04 |
| 1295966471 | Sara Anne Mohagen | Physical Therapist | 1803 S Meridian, Suite A, Puyallup, WA 98371-7513 | 2009-08-05 |
| 1669492286 | Robert W Osborne Jr. | Surgery | 1803 S Meridian, Puyallup, WA 98371-7513 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588141550 | Karen Lynn Sorensen | Massage Therapist | 922 Valley Ave Nw Suite 101, Puyallup, WA 98371 | 2018-07-23 |
| 1487140257 | Bradley Dupea | Specialist/Technologist | 5702 44th St Se, Puyallup, WA 98371 | 2018-07-05 |
| 1740778695 | Pedraum Heydari | Dentist | 109 N Meridian Suite A, Puyallup, WA 98371 | 2018-04-26 |
| 1487030359 | Jennifer Block | Dental Hygienist | 601 4th Ave Sw, Puyallup, WA 98371 | 2015-08-03 |
| 1023423431 | On Your Own Inc. | Registered Nurse | 1602 Peach Park Ln Nw, Puyallup, WA 98371 | 2014-06-24 |
| 1841614997 | Enrique Somera | Registered Nurse | 1107 29th St Nw, Puyallup, WA 98371 | 2014-02-10 |
| 1033540893 | Ching Ju Chuang | Dentist | 1002 N. Meridian, Suite 104a, Puyallup, WA 98371 | 2013-12-04 |
| 1104161876 | Denise L. Vanaman | Registered Nurse | 214 W. Main, Puyallup, WA 98371 | 2012-12-06 |
| 1336491018 | Tacoma School District | Physical Therapy Assistant | 1721 8th Ave. S.w., Puyallup, WA 98371 | 2012-10-05 |
| 1275882052 | Robert Francis Saxton | Health Educator | 1121 W. Stewart, Puyallup, WA 98371 | 2012-09-07 |
| Find all providers in zip 98371 | ||||
| Taxonomy Code | 202K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Phlebology |
| Phlebology is the medical discipline that involves the diagnosis and treatment of venous disorders, including spider veins, varicose veins, chronic venous insufficiency, venous leg ulcers, congenital venous abnormalities, venous thromboembolism and other disorders of venous origin. A phlebologist has attained a minimum of 50 hours of CME units in phlebology-related courses, and is knowledgeable of and trained in a variety of diagnostic techniques including physical examination, venous imaging techniques such as duplex ultrasound, CT and MR, plethysmographic techniques and laboratory evaluation related to venous thromboembolism. The phlebologist is also trained in a variety of therapeutic interventions, which may include compression, sclerotherapy, cutaneous vascular laser, endovenous thermoablation procedures (laser and radiofrequency) endovenous chemical ablation, surgical procedures (e.g., ambulatory phlebectomy, venous ligation), vasoactive medications and the management of venous thromboembolism. |
| Notes: Source: American College of Phlebology 12/2006. www.phelbology.org [1/1/2007: new, 7/1/2009: definition reformatted] Additional Resources: Training Programs, Fellowships, and/or Preceptorships: Certification exam is being established by the American Board of Phlebology. ACGME Accredited Residency Program Requirements: None |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871072868 | Thi Lan Huong Nguyen | Phlebology | 5165 S 160th St, Tukwila, WA 98188-2762 | 2018-08-09 |
| 1447552435 | Agape Healthcare Pllc | Phlebology | 14256 Se 83rd St, Newcastle, WA 98059-3457 | 2010-11-23 |
| 1124257720 | Nouveau Jeunesse Associates, Pllc | Phlebology | 7211 W Deschutes Ave Ste D202, Kennewick, WA 99336-7728 | 2009-07-06 |
| 1093294175 | Tuyethong Bui | Phlebology | 330 Sw 43rd St Ste L, Renton, WA 98057-4900 | 2018-08-09 |
| 1285928291 | Avena Vascular, Inc.,p.c. | Phlebology | 21616 76th Ave W, Suite 200, Edmonds, WA 98026-7512 | 2011-06-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.