Active NPI
Soonsim Kim, MA
- Massage Therapist
- Lynnwood, WA
National Provider Identifier
1881188092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60720773
- Practice address
- 17410 Highway 99 Ste 150
Lynnwood, WA 98037 - Phone
- (425) 741-9927
- NPI assigned
- Jun 20, 2018
- Last updated
- Jul 7, 2018
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA60720773 | WA | Primary |
Addresses
Primary practice location
17410 Highway 99 Ste 150
Lynnwood, WA 98037
Mailing address
17410 Highway 99 Ste 150
Lynnwood, WA 98037-3632
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA607277 | Other | WA | MASSAGE THERAPIST LICENSE |
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA60720773 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530921600000",
"number": "1881188092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17410 HIGHWAY 99 STE 150",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980373632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17410 HIGHWAY 99 STE 150",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "98037",
"telephone_number": "425-741-9927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SOONSIM",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-20",
"last_updated": "2018-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60720773",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSAGE THERAPIST LICENSE",
"identifier": "MA607277",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.