Active NPI
Kim Elaine Koyamatsu, M.D.
- Occupational Medicine Physician
- Blaine, WA
National Provider Identifier
1730279290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- 36785
- Practice address
- 4519 Grandview Rd
Blaine, WA 98230-9640 - Phone
- (360) 526-3385
- Fax
- (360) 526-4813
- NPI assigned
- Oct 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 36785 | WA | Primary |
Addresses
Primary practice location
4519 Grandview Rd
Blaine, WA 98230-9640
Mailing address
4519 Grandview Rd
Blaine, WA 98230-9640
Phone (360) 526-3385
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36785 | WA | MD | Occupational Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456272000000",
"number": "1730279290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4519 GRANDVIEW RD",
"city": "BLAINE",
"state": "WA",
"postal_code": "982309640",
"telephone_number": "360-526-3385",
"fax_number": "360-526-4813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4519 GRANDVIEW RD",
"city": "BLAINE",
"state": "WA",
"postal_code": "982309640",
"telephone_number": "360-526-3385",
"fax_number": "360-526-4813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOYAMATSU",
"first_name": "KIM",
"middle_name": "ELAINE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-13",
"last_updated": "2016-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "WA",
"license": "36785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blaine, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.