Susan Kim MD PS

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD00037239 Issued in WA

Legal business name

SUSAN KIM MD PS

Doing business as

Lake Washington Dermatology

Practice address

10117 NE 58TH St Ste 200
Kirkland, WA 98033-7450

Phone

(425) 821-6363

Fax

(425) 821-4804

NPI assigned

Sep 14, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Susan H Kim, MD

Title

Physician

Phone

(425) 821-6363

Specialties & licenses 3

Addresses

Other names 1

• Lake Washington Dermatology Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1114235942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10117 NE 58TH ST STE 200",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980337450",
            "telephone_number": "425-821-6363",
            "fax_number": "425-821-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10117 NE 58TH ST STE 200",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980337450",
            "telephone_number": "425-821-6363",
            "fax_number": "425-821-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN KIM MD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-14",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "425-821-6363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00037239",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WA",
            "license": "MD00037239",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "WA",
            "license": "MD00037239",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Washington Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Superland LLC
• Surgery Suite Specialist, LLC.
• Surgical Center Anesthesiologists
• Pamela Nancy Sursely, DDS
• Susan Kim DDS (Evergreen Pediatric Dentistry)
• Susan Sooyoung Kim MD PHD P.C.
• Pauline Jane Sutanto
• Kelsey Metcalfe Sutter, DPT
• Jasmine Svare
• Gina M Swan, BT

• Dermatology Physician in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Dermatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.