Basic Information
| Provider Information | |||||||||
| NPI: | 1457408064 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIM | ||||||||
| FirstName: | STEVE | ||||||||
| MiddleName: | HOONSANG | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 805 MADISON ST | ||||||||
| Address2: | SUITE 901 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981041172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062648100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1750 112TH AVE NE | ||||||||
| Address2: | SUITE D050 | ||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980043752 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062153850 | ||||||||
| FaxNumber: | 2062153870 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2007 | ||||||||
| LastUpdateDate: | 08/26/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | MD00042157 | WA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 7843KI | 01 | WA | REGENCE INSURANCE NUM | OTHER | 8349011 | 05 | WA | MEDICAID | 3732KI | 01 | WA | REGENCE INSURANCE NUM | OTHER | 4385KI | 01 | WA | REGENCE INSURANCE NUM | OTHER | 8934826 | 01 | WA | DEPT OF LABOR AND INDUSTR | OTHER | 8438KI | 01 | WA | REGENCE INSURANCE NUM | OTHER |