Active NPI
Sun B Kim, PHARMACIST
- Pharmacist
- Puyallup, WA
National Provider Identifier
1801197090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 00014265
- Practice address
- 611 S Meridian
Puyallup, WA 98371-5907 - Phone
- (253) 841-1534
- Fax
- (253) 840-3744
- NPI assigned
- Nov 4, 2010
- Sex
- Male
- 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 | 00014265 | WA | Primary |
Addresses
Primary practice location
611 S Meridian
Puyallup, WA 98371-5907
Mailing address
12015 183Rd St E
Puyallup, WA 98374-9169
Phone (360) 893-7929
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 |
|---|---|---|---|
| 00014265 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288828800000",
"number": "1801197090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12015 183RD ST E",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983749169",
"telephone_number": "360-893-7929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 S MERIDIAN",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983715907",
"telephone_number": "253-841-1534",
"fax_number": "253-840-3744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SUN",
"middle_name": "B",
"name_prefix": "Mr.",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-04",
"last_updated": "2010-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "00014265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.