Active NPI
Tae Hoon Kim
- Massage Therapist
- Bellevue, WA
National Provider Identifier
1962982306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60841588
- Practice address
- 12721 NE Bel Red Rd Ste 130
Bellevue, WA 98005-2653 - Phone
- (425) 484-2548
- NPI assigned
- Aug 15, 2018
- Sex
- Male
- 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 | MA60841588 | WA | Primary |
Addresses
Primary practice location
12721 NE Bel Red Rd Ste 130
Bellevue, WA 98005-2653
Mailing address
5830 119TH St SE
Snohomish, WA 98296-6967
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 |
|---|---|---|---|
| MA60841588 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TK Health & Wellness LLC | Massage Therapist | Current | Accepting new patients |
Locations
12721 NE Bel Red Rd
Ste 130
Bellevue, WA 98005
Phone (425) 484-2548
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1962982306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5830 119TH ST SE",
"city": "SNOHOMISH",
"state": "WA",
"postal_code": "982966967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12721 NE BEL RED RD STE 130",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980052653",
"telephone_number": "425-484-2548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "TAE HOON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-15",
"last_updated": "2024-07-15",
"certification_date": "2024-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60841588",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.