Active NPI
Jungmi Kim
- Pharmacy Technician
- Lakewood, WA
National Provider Identifier
1720743461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- VA00049476
- Practice address
- 5700 100TH St SW
Lakewood, WA 98499-2752 - Phone
- (253) 588-3666
- Fax
- (253) 588-1922
- NPI assigned
- Nov 8, 2021
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | VA00049476 | WA | Primary |
Addresses
Primary practice location
5700 100TH St SW
Lakewood, WA 98499-2752
Mailing address
5700 100TH St SW
Lakewood, WA 98499-2752
Phone (253) 588-3666
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.riteaid.com | THRIFTY PAYLESS INC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| VA00049476 | WA | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636329600000",
"number": "1720743461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5700 100TH ST SW",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984992752",
"telephone_number": "253-588-3666",
"fax_number": "253-588-1922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5700 100TH ST SW",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984992752",
"telephone_number": "253-588-3666",
"fax_number": "253-588-1922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JUNGMI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-08",
"last_updated": "2021-11-08",
"certification_date": "2021-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "WA",
"license": "VA00049476",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "www.riteaid.com",
"affiliation": "Y",
"affiliationName": "THRIFTY PAYLESS INC",
"address_1": "5700 100th St SW",
"city": "Lakewood",
"state": "WA",
"country_code": "US",
"postal_code": "984992752",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.