Individual provider Active NPI

Inki Kim

  • Acupuncturist
  • Everett, WA
National Provider Identifier
1477209559
Registry record updated Feb 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC60073357 Issued in WA
Practice address
11419 19TH Ave SE Ste C106
Everett, WA 98208-5120
Phone
(425) 523-8878
Fax
(425) 523-8868
NPI assigned
Feb 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC60073357 WA Primary

Addresses

Primary practice location

11419 19TH Ave SE Ste C106
Everett, WA 98208-5120

Mailing address

11419 19TH Ave SE Ste C106
Everett, WA 98208-5120
Phone (425) 523-8878

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

State licenses

LicenseStateTypeSpecialty
AC60073357WAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Mind-Body LLC CurrentSince Mar 6, 2022 Accepting new patients
Silverlake Clinic Inc. Acupuncturist PastSince Mar 6, 2022 Accepting new patients

Locations

11419 19th Ave SE
Ste C106
Everett, WA 98208
Phone (425) 523-8878

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.

NPI Registry JSON

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

{
    "created_epoch": "1645833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645833600000",
    "number": "1477209559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11419 19TH AVE SE STE C106",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982085120",
            "telephone_number": "425-523-8878",
            "fax_number": "425-523-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11419 19TH AVE SE STE C106",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982085120",
            "telephone_number": "425-523-8878",
            "fax_number": "425-523-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "INKI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-26",
        "last_updated": "2022-02-26",
        "certification_date": "2022-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC60073357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2022; 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.