SOO-JEONG KIM (NPI# 1215952288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215952288 |
| Entity Type | Individual |
| Full Name | SOO-JEONG KIM |
| Credential | M.D. |
| Practice Address |
4909 25th Ave Ne Seattle Childrens Autism Center Seattle WA 98105-4107 |
| Practice Telephone | 2069878080 |
| Practice Fax Number | 2069878081 |
| Mailing Telephone | 2069878080 |
| Mailing Fax Number | 2069878081 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2016-06-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
ME96302 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
4909 25TH AVE NE SEATTLE CHILDRENS AUTISM CENTER |
| City | SEATTLE |
| State | WA |
| Zip Code | 98105-4107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609485242 | Jill Jacqueline Locke | Psychologist | 4909 25th Ave Ne, Seattle, WA 98105-4107 | 2020-07-29 |
| 1043717606 | Elizabeth Hatzenbuhler | Behavioral Analyst | 4909 25th Ave Ne, Seattle, WA 98105-4107 | 2018-04-10 |
| 1730604026 | Katelyn Cotter | Nurse Practitioner | 4909 25th Ave Ne, Seattle, WA 98105-4107 | 2017-08-07 |
| 1083141253 | Blayne D Stemple | Behavioral Analyst | 4909 25th Ave Ne, Seattle, WA 98105-4107 | 2017-05-17 |
| 1295106813 | Molly Ewbank | Counselor | 4909 25th Ave Ne, Seattle, WA 98105-4107 | 2015-10-08 |
| 1568833184 | Kelley Cade | Counselor | 4909 25th Ave Ne, Suite 120, Seattle, WA 98105-4107 | 2015-10-08 |
| 1114398872 | Seattle Children's Hospital | Counselor | 4909 25th Ave Ne, Seattle, WA 98105-4107 | 2015-10-07 |
| 1467828772 | Tara Godinho | Behavioral Analyst | 4909 25th Ave Ne, Suite 120, Seattle, WA 98105-4107 | 2015-08-20 |
| 1386050748 | Eunice Barron | Behavioral Analyst | 4909 25th Ave Ne, Seattle, WA 98105-4107 | 2014-07-07 |
| 1144660788 | Coleen Mary Gilchrist | Occupational Therapist | 4909 25th Ave Ne, Suite 200, Seattle, WA 98105-4107 | 2013-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326662396 | Dale Justin Podolsky | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Ob.9.520, Seattle Children's, Seattle, WA 98105 | 2020-06-04 |
| 1376170878 | Andrew Crompton Yazman | Pediatrics | 4800 Sand Point Way, Ne Oc.7.830, Seattle, WA 98105 | 2020-03-25 |
| 1427688845 | Daniela Michell Zepeda | Behavioral Analyst | 4616 25th Ave Ne Pmb 437, Seattle, WA 98105 | 2020-01-24 |
| 1255981189 | Emily King | Student in an Organized Health Care Education/Training Program | Mark Hawkins, Pa-c, Mpas, 4311 11th Ave Ne Suite 200, WA 98105 | 2019-09-12 |
| 1821659327 | Sara Katherine Horne | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Mb.11.500, Department of Anesthesiology and Pain Medicine, Seattle, Seattle, WA 98105 | 2019-06-25 |
| 1881252575 | Darryl Lee Wright | Peer Specialist | Gossett Place, 4719 12th Ave Ne, Seattle, WA 98105 | 2019-05-29 |
| 1487117891 | Nirupama Madhavan | Behavioral Analyst | 5001 25th Ave Ne, Seattle, WA 98105 | 2019-04-11 |
| 1780155648 | Eryn R Mcentee | Naturopath | 2216 Ne46th St, Seattle, WA 98105 | 2018-12-17 |
| 1356811921 | Kyle Leland Bernbach | Massage Therapist | 5224 Ravenna Ave Ne, Seattle, WA 98105 | 2018-11-27 |
| 1548742380 | Janal Kim | Physician Assistant | 4726 11th Ave Ne, Apt 511, Seattle, WA 98105 | 2018-08-29 |
| Find all providers in zip 98105 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235792326 | Wellpsyche Seattle PC | Psychiatry & Neurology | 801 2nd Ave Ste 800, Seattle, WA 98104-1573 | 2019-04-15 |
| 1437288768 | Diane C Stein | Psychiatry & Neurology | 4026 Ne 55th St Ste E200, Seattle, WA 98105-2263 | 2007-03-04 |
| 1902996325 | Jack Martin Reiter | Psychiatry & Neurology | 726 Braodway, Suite 303, Seattle, WA 98122-4321 | 2006-10-14 |
| 1962591479 | Catherine Jackson Kuniyoshi | Psychiatry & Neurology | 1501 Western Ave Ste 110, Seattle, WA 98101-3500 | 2006-10-12 |
| 1447343082 | Tina Lee | Psychiatry & Neurology | 1200 5th Ave, Suite 800, Seattle, WA 98101-3132 | 2006-10-02 |
| 1437125044 | Thomas Frederick Semper | Psychiatry & Neurology | 509 Olive Way Ste 204, Seattle, WA 98101-1726 | 2006-02-23 |
| 1679951107 | Nicholas Meinhardt | Psychiatry & Neurology | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2015-05-17 |
| 1649615360 | Association of University Physicians | Psychiatry & Neurology | 325 9th Ave, Chrmc, Seattle, WA 98104-2420 | 2013-05-08 |
| 1639463367 | Douglas Andrew Russell | Psychiatry & Neurology | 4800 Sand Point Way Ne, Seattle, WA 98105 | 2011-05-28 |
| 1932499670 | Nina De Lacy | Psychiatry & Neurology | 1959 Ne Pacific St, Box 356560, Seattle, WA 98195-6560 | 2011-04-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.