MI SUN KIM (NPI# 1679925168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679925168 |
| Entity Type | Individual |
| Full Name | MI SUN KIM |
| Credential | APRN |
| Practice Address |
4011 Talbot Rd S Ste 500 Renton WA 98055-5782 |
| Mailing Address |
3600 Lind Ave Sw Suite 100 Attn Credentialing Renton WA 98057-4970 |
| Practice Telephone | 4256903482 |
| Practice Fax Number | 4256909082 |
| Mailing Telephone | 4256902715 |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2020-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN60371091 | WA | Nursing Service Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AP60660933 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2068715 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 525 Lilly Rd Ne, Ste 200, Olympia, WA 985065101 | 3604934510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487774980 | Mi Sun Kim | Nurse Practitioner | 525 E 68th St, Cardiac Cath Lab F439, New York, NY 10021-4870 | 2007-03-29 |
| Street Address |
4011 TALBOT RD S STE 500 |
| City | RENTON |
| State | WA |
| Zip Code | 98055-5782 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013987841 | Ting-wei Yang | Internal Medicine | 4011 Talbot Rd S Ste 500, Renton, WA 98055-5782 | 2006-01-24 |
| 1194200667 | Jamie Lea Meyer | Nurse Practitioner | 4011 Talbot Rd S Ste 500, Renton, WA 98055-5782 | 2018-10-01 |
| 1235577883 | Kenneth Y Igbalode | Internal Medicine | 4011 Talbot Rd S Ste 500, Renton, WA 98055-5782 | 2013-06-05 |
| 1467705921 | Mirela Elena Goetzke | Nurse Practitioner | 4011 Talbot Rd S Ste 500, Renton, WA 98055-5782 | 2012-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965750 | Proliance Surgery Center At Valley, LLC | Clinic/Center | 4009 Talbot Road S, Suite 200, Renton, WA 98055 | 2020-06-01 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1154878668 | Nelson Family Dentistry | Dentist | 19221 108th Ave Se Suite #2, Renton, WA 98055 | 2016-09-01 |
| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295193787 | Frank Ross Jr. | Nurse Practitioner | 2218 Kennewick Pl Ne, Renton, WA 98056-2295 | 2016-01-29 |
| 1790101616 | Daniel Smith | Nurse Practitioner | 11100 Se Petrovitsky Rd Apt C206, Renton, WA 98055-5645 | 2014-03-17 |
| 1659702058 | Maricel Hinkulow | Nurse Practitioner | 16224 Se 138th Pl, Renton, WA 98059-6837 | 2013-12-10 |
| 1558600650 | Kalyan Dandala, Md Pllc | Nurse Practitioner | 350 S 38th Ct Ste 100, Renton, WA 98055-5777 | 2013-02-08 |
| 1306133665 | Amy Louise Cheng | Nurse Practitioner | 1107 Sw Grady Way Ste 100, Renton, WA 98057-5217 | 2011-07-06 |
| 1881062990 | L'oreal Kennedy | Nurse Practitioner | 4033 Talbot Rd S Ste 470, Renton, WA 98055-5700 | 2015-09-04 |
| 1386958692 | Lourdes C Jose | Nurse Practitioner | 3600 Lind Ave Sw, Ste 170, Renton, WA 98057-4934 | 2010-07-28 |
| 1275710949 | Price Medical, Inc | Nurse Practitioner | 400 S 43rd St, Nw Pavillion Wound Center, Renton, WA 98055-5714 | 2008-01-24 |
| 1821218124 | Wendy Wank | Nurse Practitioner | 400 S 43rd St, Renton, WA 98055-5714 | 2007-04-27 |
| 1821120841 | Dorothy Suzanne Pianko | Nurse Practitioner | 4033 Talbot Rd S, Suite 500, Renton, WA 98055-5772 | 2007-03-12 |
| Find all providers in RENTON | ||||
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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.