Individual provider Active NPI

Marianne Kim, M.D.

  • Diagnostic Radiology Physician
  • Tacoma, WA
National Provider Identifier
1699079640
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD60640466 Issued in WA
Practice address
1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone
(253) 761-4200
Fax
(253) 761-4201
NPI assigned
Jan 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD60640466 WA Primary

Addresses

Primary practice location

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900

Mailing address

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone (253) 761-4200

Other identifiers 1

IdentifierTypeStateIssuer
2057229MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160802002546 WA Practitioner - Diagnostic RadiologyPractitioner - Other (Physician) 4183945579 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albert Einstein College of Medicine of Yeshiva University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tra-Minw P SGroup PAC ID 2163316167, 152 clinicians
The Carol Milgard Breast CenterGroup PAC ID 8022172212, 12 clinicians

Practice addresses (Care Compare)

16251 Sylvester Rd SW
Burien, WA 98166-3017
Phone (253) 841-4353

17700 SE 272ND St
Covington, WA 98042-4951
Phone (253) 841-4353

222 15TH Ave SE
Puyallup, WA 98372-3754
Phone (253) 841-4353

3402 S 18TH St
Tacoma, WA 98405-1903
Phone (253) 841-4353

34515 9TH Ave S
Federal Way, WA 98003-6761
Phone (253) 841-4353

4525 S 19TH St
Tacoma, WA 98405-1106
Phone (253) 759-2622

500 Lilly Rd NE
Suite 160
Olympia, WA 98506-9107
Phone (253) 841-4353

Hospital & facility affiliations

  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
  • St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141
  • St Elizabeth Hospital Hospital, Enumclaw, WA, CCN 501335
  • Multicare Covington Medical Center Hospital, Covington, WA, CCN 500154
  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Union Avenue Open MRI LLC CurrentSince Jan 1, 2017 Accepting new patients
Tra Medical Imaging Centers LLC CurrentSince Dec 1, 2025 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Aug 1, 2016 Accepting new patients
Proliance Surgeons Inc P S CurrentSince Jan 7, 2022 Accepting new patients
Tra-Minw P S CurrentSince Jan 1, 2017 Accepting new patients
Tra-Minw P S CurrentSince Jan 1, 2017 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Aug 1, 2016 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Jan 7, 2022 Accepting new patients

Locations

21110 Sr 410 E
Ste 110
Bonney Lake, WA 98391

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030

222 15th Ave SE
Puyallup, WA 98372

1101 Madison St
Ste 580
Seattle, WA 98104
Phone (206) 400-7625

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

4525 S 19th St
Tacoma, WA 98405
Phone (253) 759-2622

1201 Pacific Ave
Ste 400
Tacoma, WA 98402
Phone (253) 300-8447

2502 S Union Ave
Tacoma, WA 98405
Phone (253) 759-5900

1304 Fawcett Ave
Ste 100
Tacoma, WA 98402
Phone (253) 680-3372

3402 S 18th St
Tacoma, WA 98405
Phone (253) 383-1099

Interoperability endpoints

  • Direct secure messaging: marianne.kim.p42@direct.proliance.nextgenshare.com
  • FHIR API: https://app.meldrx.com/api/fhir/ei-trami

Organizations & group practices 10

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1699079640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021900",
            "telephone_number": "253-761-4200",
            "fax_number": "253-383-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021900",
            "telephone_number": "253-761-4200",
            "fax_number": "253-761-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MARIANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-05",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60640466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2057229",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.