Jessica D Kim, MPH, RD, CD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI60488126 Issued in WA

Practice address

751 NE Blakely Dr
3Rd Floor
Issaquah, WA 98029-6201

Phone

(425) 313-7947

NPI assigned

Oct 12, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1376914721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 BROADWAY",
            "address_2": "STE 800",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224396",
            "telephone_number": "206-215-6670",
            "fax_number": "206-215-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 NE BLAKELY DR",
            "address_2": "3RD FLOOR",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296201",
            "telephone_number": "425-313-7947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JESSICA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "MPH, RD, CD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI60488126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Pruess Nevins MD PLLC
• Alice J. Kim, M.D.
• David Hak Kim, LMHC
• Eun Hee Kim, D.D.S.
• Jason Kim, MD
• Joyce Kim, DPT
• Indigo Kimmel, BT
• Travis J. Kinane, DO
• King Co Fire Dist No 10
• Corie Megan King-Langin, FNP-BC

• Registered Dietitian in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; 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.