Provider Demographics
NPI:1386778124
Name:KIM, HANG SIG (MD)
Entity type:Individual
Prefix:DR
First Name:HANG
Middle Name:SIG
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 N 200TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3213
Mailing Address - Country:US
Mailing Address - Phone:206-533-6181
Mailing Address - Fax:206-533-2380
Practice Address - Street 1:1207 N 200TH ST STE 105
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3213
Practice Address - Country:US
Practice Address - Phone:206-533-6181
Practice Address - Fax:206-533-2380
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00029021208D00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1076736Medicaid
WA1076736Medicaid
WAF21159Medicare UPIN