THEODORE Y KIM (NPI# 1952325359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952325359 |
| Entity Type | Individual |
| Full Name | THEODORE Y KIM |
| Credential | D.O. |
| Practice Address |
1415 E Kincaid St Mount Vernon WA 98274-4126 |
| Practice Telephone | 3604244111 |
| Mailing Telephone | 3604244111 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2008-05-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | OP00002076 | WA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8453581 | 05 | |
| WA | REGENCE BLUE SHIELD | 3718KI | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275949463 | Theodore Kim | Internal Medicine | 600 Highland Ave, Madison, WI 53792-0001 | 2014-07-08 |
| 1982694618 | Theodore Tae-hun Kim | Allergy & Immunology | 4229 Lafayette Center Dr, Unit 1760, Chantilly, VA 20151-1267 | 2005-10-25 |
| 1275538845 | Theodore Y Kim | Internal Medicine | 7350 Van Dusen Rd, Ste 210, Laurel, MD 20707-5268 | 2005-06-20 |
| Street Address |
1415 E KINCAID ST |
| City | MOUNT VERNON |
| State | WA |
| Zip Code | 98274-4126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750360707 | Rick A Wenning | Pharmacist | 1415 E Kincaid St, Mount Vernon, WA 98274-4126 | 2006-01-10 |
| 1396367561 | Sarah Zubair | Student in an Organized Health Care Education/Training Program | 1415 E Kincaid St, Mount Vernon, WA 98274-4126 | 2020-05-11 |
| 1538798889 | Savannah Martha Broadlick | Student in an Organized Health Care Education/Training Program | 1415 E Kincaid St, Mount Vernon, WA 98274-4126 | 2020-04-07 |
| 1639708175 | Melinda Mae Mantooth | Student in an Organized Health Care Education/Training Program | 1415 E Kincaid St, Mount Vernon, WA 98274-4126 | 2020-04-06 |
| 1699303974 | Matthew Kon | Student in an Organized Health Care Education/Training Program | 1415 E Kincaid St, Mount Vernon, WA 98274-4126 | 2020-03-31 |
| 1518595412 | Rhandy Ceballos | Student in an Organized Health Care Education/Training Program | 1415 E Kincaid St, Mount Vernon, WA 98274-4126 | 2020-03-28 |
| 1467089235 | Khadij Assani | Student in an Organized Health Care Education/Training Program | 1415 E Kincaid St, Mount Vernon, WA 98274-4126 | 2020-03-23 |
| 1689210874 | Hospitalist Medicine Physicians of California - San Leandro, PC | Internal Medicine | 1415 E Kincaid St, Mount Vernon, WA 98274-4126 | 2019-11-22 |
| 1760023170 | Jessica K. Fletcher | Physical Therapist | 1415 E Kincaid St, Mount Vernon, WA 98274-4126 | 2019-10-07 |
| 1932769007 | Kerrie Steffan | Physical Therapist | 1415 E Kincaid St, Mount Vernon, WA 98274-4126 | 2019-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881123438 | Ankur Tarun Sanghvi | Peer Specialist | 209 Milwaukee Steet, 209, Mount Vernon, WA 98274 | 2017-06-07 |
| 1932647187 | Claudia Diaz | Counselor | 23550 Garden St, Mount Vernon, WA 98274 | 2017-02-08 |
| 1871042002 | Richard Simcock Dds, Ps | Dentist | 130 S 15th St Suite 101, Mount Vernon, WA 98274 | 2016-09-29 |
| 1528228186 | Parampreet Singh Ghuman | Internal Medicine | 121 S. 12th St, Ste B, Mount Vernon, WA 98274 | 2008-06-16 |
| 1699940874 | Eugene Villanueva De Guzman | Internal Medicine | 208 S Hospital Pkwy, Mount Vernon, WA 98274 | 2008-04-28 |
| 1871775122 | Matthew John Novak | Internal Medicine | 208 Hospital Pkwy, Mount Vernon, WA 98274 | 2007-11-28 |
| 1568658797 | Emily A K Bianconi | Nurse Practitioner | 2101 Little Mountain Lane, Mount Vernon, WA 98274 | 2007-09-21 |
| 1659576981 | Peggy Randall | Counselor | 1420 S 12th, Mount Vernon, WA 98274 | 2007-06-18 |
| 1194937037 | Cascade Neurologic Clinic, Inc, P.s. | Clinic/Center | 1315 East Division St., Mt. Vernon, WA 98274 | 2007-05-04 |
| 1427171297 | Keri L D Halgren | Dentist | 1711 E Division Street, Mt Vernon, WA 98274 | 2007-04-09 |
| Find all providers in zip 98274 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295356459 | Kendra Celeste Williams | Specialist | 300 Hayward Ave Apt 2h, Mount Vernon, NY 10552-1729 | 2020-04-29 |
| 1912551938 | Tania Monique Marshall | Specialist | 340 Garden Ave, Mount Vernon, NY 10553-2014 | 2019-07-29 |
| 1801357090 | Camille Blackwood | Specialist | 55 Bonita Vista Rd, Mount Vernon, NY 10552-1301 | 2019-03-29 |
| 1043717325 | Rhea Elizabeth Zificsak | Specialist | 30 Fleetwood Ave Apt 1d, Mount Vernon, NY 10552-2854 | 2018-04-12 |
| 1457866477 | Angelina Jaqueline Lewis | Specialist | 58 Parkway W, Mount Vernon, NY 10552-1141 | 2017-12-13 |
| 1083126551 | Christina Storm | Specialist | 514 Gramatan Ave Apt 7a, Mount Vernon, NY 10552-3052 | 2017-10-24 |
| 1386177350 | La Sheune Cantey | Specialist | 465 E Lincoln Ave Apt 110, Mount Vernon, NY 10552-3539 | 2017-04-06 |
| 1477001550 | Daysi N. Mina | Specialist | 55 Ehrbar Ave, Apt 3d, Mount Vernon, NY 10552-2444 | 2016-09-16 |
| 1982057410 | Gina Marie Giordano | Specialist | 40 E Birch St, Apt. # 3 D, Mount Vernon, NY 10552-1838 | 2016-07-20 |
| 1013366087 | Breonne Lewis | Specialist | 99 Pennsylvania Ave, Mount Vernon, NY 10552-2419 | 2016-06-09 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 98274 |
Please comment or provide details below to improve the information on THEODORE Y KIM.
| 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.