Carols Kreation and Boutique LLC

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

CAROLS KREATION AND BOUTIQUE LLC

Doing business as

myles heart outeach
myles heart outreach

Practice address

18407 Pacific Ave S Ste 5
Spanaway, WA 98387-8374

Phone

(206) 403-6781

NPI assigned

Mar 19, 2024

Last updated

Mar 19, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

CAROLS KREATION AND BOUTIQUE LLCAs reported in NPPES

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

Authorized official

Name

Misun Jung Ho KimNPI 1275393233

Title

Owner

Phone

(206) 403-6781

Specialties & licenses 1

Addresses

Other names 2

• myles heart outeach Doing business as
• myles heart outreach Doing business as

Part of

Carols Kreation and Boutique LLC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Misun Carolyn Jung Ho Kim

  • Counselor
  • Spanaway, WA
  • NPI 1275393233
  NPD Authorized official

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1124888193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9206 195TH STREET CT E",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983388476",
            "telephone_number": "206-403-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18407 PACIFIC AVE S STE 5",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983878374",
            "telephone_number": "206-403-6781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLS KREATION AND BOUTIQUE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLS KREATION AND BOUTIQUE LLC",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "JUNG HO KIM",
        "authorized_official_first_name": "MISUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-403-6781"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "myles heart outeach",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "myles heart outreach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Susan Callaway
• Riki Camacho, LMHC
• Thomas James Campbell, D.C.
• Joseph Robert Canto Jr., RPH
• Phillip Cappetto, ATC
• Najela Ladawn Carter
• Kimberlynn Marie Chandler-McDaniel, LMP
• Asia Chatman
• Joan Cheptum-Maritim, RN
• Joshua H Chipperfield, RN

• Local Education Agency (LEA) in Spanaway, WA
• Providers in Spanaway, WA by specialty
• Local Education Agency (LEA) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.