Active NPI
Connie Kim, PHARMD
- Ambulatory Care Pharmacist
- Snohomish, WA
National Provider Identifier
1457133639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- PH61170525
- Practice address
- 401 2ND St
Snohomish, WA 98290-3008 - Phone
- (360) 629-1500
- NPI assigned
- Oct 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | PH61170525 | WA | Primary |
Addresses
Primary practice location
401 2ND St
Snohomish, WA 98290-3008
Mailing address
7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414
Other practice location 1
7205 265th St NW
Stanwood, WA 98292-6221
Phone (360) 629-1500
Other practice location 2
904 7th Ave
Seattle, WA 98104-1132
Phone (206) 860-4669
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH61170525 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Polyclinic PLLC | Past | Accepting new patients | |
| Optum Care Washington PLLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Ambulatory Surgical Clinic/Center
- Everett, WA
- NPI 1154318103
-
dba Optum Care Washington
- Durable Medical Equipment & Medical Supplies
- Seattle, WA
- NPI 1346620200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785110400000",
"number": "1457133639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7600 EVERGREEN WAY",
"city": "EVERETT",
"state": "WA",
"postal_code": "982036421",
"telephone_number": "206-860-5414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 2ND ST",
"city": "SNOHOMISH",
"state": "WA",
"postal_code": "982903008",
"telephone_number": "360-629-1500"
}
],
"practiceLocations": [
{
"address_1": "7205 265th St NW",
"address_purpose": "LOCATION",
"city": "Stanwood",
"state": "WA",
"postal_code": "982926221",
"country_code": "US",
"telephone_number": "360-629-1500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "904 7th Ave",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981041132",
"country_code": "US",
"telephone_number": "206-860-4669",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "CONNIE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-20",
"last_updated": "2026-07-27",
"certification_date": "2026-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "WA",
"license": "PH61170525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Snohomish, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.