| NPI | 1194735530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE W KIM Medical Director/Owner 253-536-2824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 207R00000X Internal Medicine | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2025-09-11 |