Basic Information
| Provider Information | |||||||||
| NPI: | 1326457839 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIM-ORDEN | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | H. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2409 N 45TH ST | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981036907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2066338100 | ||||||||
| FaxNumber: | 2066336107 | ||||||||
| Practice Location | |||||||||
| Address1: | 2409 N 45TH ST | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981036907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2066338100 | ||||||||
| FaxNumber: | 2066336107 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2014 | ||||||||
| LastUpdateDate: | 11/18/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | MD61054853 | WA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0114X | A138771 | CA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Adult Reconstructive Orthopaedic Surgery | 207XS0114X | MD61054853 | WA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Adult Reconstructive Orthopaedic Surgery |
No ID Information.