Active NPI
Soohyun Kim, PHARM.D.
- Pharmacist
- Everett, WA
National Provider Identifier
1720465123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH 60481998
- Practice address
- 111 SE Everett Mall Way Ste A100
Everett, WA 98208-3208 - Phone
- (800) 330-3665
- Fax
- (800) 982-2730
- NPI assigned
- May 5, 2015
- Last updated
- May 5, 2015
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH 60481998 | WA | Primary |
Addresses
Primary practice location
111 SE Everett Mall Way Ste A100
Everett, WA 98208-3208
Mailing address
16100 SW 72ND Ave
Portland, OR 97224-7745
Phone (800) 330-3665
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 |
|---|---|---|---|
| PH 60481998 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pharmacy Corporation of America | Past | Accepting new patients | |
| Pharmacy Corporation of America | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Propac Payless Pharmacy
- Long Term Care Pharmacy
- Everett, WA
- NPI 1093799843
-
- Pharmacy
- Vancouver, WA
- NPI 1184171704
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430784000000",
"number": "1720465123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16100 SW 72ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972247745",
"telephone_number": "800-330-3665",
"fax_number": "800-982-2730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 SE EVERETT MALL WAY STE A100",
"city": "EVERETT",
"state": "WA",
"postal_code": "982083208",
"telephone_number": "800-330-3665",
"fax_number": "800-982-2730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SOOHYUN",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-05",
"last_updated": "2015-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH 60481998",
"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 May 5, 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.