Individual provider Active NPI

Seong Eun Kim, OTR/L

  • Occupational Therapist
  • Olympia, WA
National Provider Identifier
1669850491
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT61653859 Issued in WA
Practice address
3901 Capital Mall Dr SW Ste D
Olympia, WA 98502-8654
Phone
(360) 709-6221
Fax
(360) 359-4727
NPI assigned
May 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056-011077 IL
Occupational Therapist 225X00000X OT61653859 WA Primary

Addresses

Primary practice location

3901 Capital Mall Dr SW Ste D
Olympia, WA 98502-8654

Mailing address

3901 Capital Mall Dr SW Ste D
Olympia, WA 98502-8654
Phone (360) 709-6221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250319002079 WA Practitioner - Occupational Therapist in Private Practice 0547575466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, shared by 46 NPIs, 2,312 clinicians

Practice addresses (Care Compare)

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Merit-based Incentive Payment System (MIPS)

Final score
84.02 of 100Reported as group
Quality
68.63
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056-011077ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Olympia Orthopaedic Associates PLLC CurrentSince Mar 11, 2025 Accepting new patients
Olympia Orthopaedic Associates, PLLC CurrentSince Mar 11, 2025 Accepting new patients

Locations

615 Lilly Rd NE
Ste 240
Olympia, WA 98506
Phone (360) 413-3850

3901 Capital Mall Dr SW
Ste D
Olympia, WA 98502
Phone (360) 709-6221

Interoperability endpoints

  • Direct secure messaging: seongeun.kim@ro.eclinicaldirectplus.com
  • Direct secure messaging: seong.kim.1@5512.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/5512/brand/1/csg/1/fhir/r4

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": "1431475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1669850491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 CAPITAL MALL DR SW STE D",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028654",
            "telephone_number": "360-709-6221",
            "fax_number": "360-359-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 CAPITAL MALL DR SW STE D",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028654",
            "telephone_number": "360-709-6221",
            "fax_number": "360-359-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SEONG",
        "middle_name": "EUN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-13",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-011077",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT61653859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.