Provider Demographics
NPI:1407661135
Name:KIM, ALEXANDER YOUNG SIK
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:YOUNG SIK
Last Name:KIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 343
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-0343
Mailing Address - Country:US
Mailing Address - Phone:425-984-3770
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 343
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-0343
Practice Address - Country:US
Practice Address - Phone:425-984-3770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist