Individual provider Active NPI

Kyung-Eun Kim, LL 60284713

  • Speech-Language Pathologist
  • Federal Way, WA
National Provider Identifier
1780934364
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL 60284713 Issued in WA
Practice address
33330 8TH Ave S
Federal Way Public Schools (Mirror Lake Elementary)
Federal Way, WA 98003-6325
Phone
(253) 945-3331
NPI assigned
Sep 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X LL 60284713 WA Primary

Addresses

Primary practice location

33330 8TH Ave S
Federal Way Public Schools (Mirror Lake Elementary)
Federal Way, WA 98003-6325

Mailing address

29544 54TH CT S
Auburn, WA 98001-3714
Phone (253) 835-6185

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

LicenseStateTypeSpecialty
LL 60284713WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1780934364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29544 54TH CT S",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980013714",
            "telephone_number": "253-835-6185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33330 8TH AVE S",
            "address_2": "FEDERAL WAY PUBLIC SCHOOLS (MIRROR LAKE ELEMENTARY)",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036325",
            "telephone_number": "253-945-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYUNG-EUN",
        "credential": "LL 60284713",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL 60284713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.