YOUNGTAE KIM (NPI# 1609374867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609374867 |
| Entity Type | Individual |
| Full Name | YOUNGTAE KIM |
| Credential | PHARMD, MBA |
| Practice Address |
401 W Poplar St Walla Walla WA 99362-2846 |
| Mailing Address |
187 Nw Maria St Unit 1 College Place WA 99324-2152 |
| Practice Telephone | 5035194302 |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2018-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
PH60781611 | WA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | PHAMACIST LICENSE | PH60781611 | 01 |
| Street Address |
401 W POPLAR ST |
| City | WALLA WALLA |
| State | WA |
| Zip Code | 99362-2846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720083686 | Timothy G Caudill | Anesthesiology | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2005-06-16 |
| 1609476605 | Aimy Ung | Pharmacist | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2020-10-28 |
| 1043856578 | Robert John Brawders | Pharmacist | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2019-11-19 |
| 1205472735 | Timothy Steven Zaske | Pharmacist | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2019-11-19 |
| 1174164842 | Nika Marie Carter-lee | Registered Nurse | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2019-10-03 |
| 1215578026 | Shelby Paulsen | Health Educator | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2019-10-02 |
| 1023667714 | Jennifer Simpson | Registered Nurse | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2019-09-05 |
| 1598311524 | Paige Ayako Akiyama | Pharmacist | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2019-08-15 |
| 1417518739 | Nicholas Wayne Begick | Dietitian, Registered | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2019-06-26 |
| 1760944359 | Natasha Montgomery | Registered Nurse | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2019-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164065959 | Kevin Gia-minh Phan | Optometrist | Walla Walla Vamc Bldg 86, Walla Walla, WA 99362 | 2019-10-24 |
| 1659836401 | Arlene Lavonne Whitney | Social Worker | 1361 Dalles Military Road, Walla Walla, WA 99362 | 2019-02-06 |
| 1053880674 | Julie Ann Cooke | Speech-Language Pathologist | Providence St. Mary Medical Center, 401 W. Poplar St., Walla Walla, WA 99362 | 2018-11-14 |
| 1558887133 | Chantey Walker | Massage Therapist | 1840 Pleasant St, Walla Walla, WA 99362 | 2017-08-16 |
| 1447798723 | Carrie S Diede | Speech-Language Pathologist | 410 West Poplar Street, Rehabilitation Services, Walla Walla, WA 99362 | 2017-02-07 |
| 1235584103 | Anchor Point Counseling Pllc | Clinic/Center | 2330 Eastgate St. Ste. 140, Walla Walla, WA 99362 | 2016-04-28 |
| 1548627011 | Washington State Walla Walla Veterans Home | Skilled Nursing Facility | 92 Wainwright Drive, Walla Walla, WA 99362 | 2016-01-28 |
| 1073926200 | Sherry Goff | Registered Nurse | 11120 W Rose St, Family Medical Center, Walla Walla, WA 99362 | 2014-06-05 |
| 1538597935 | Michael Wade Gillespie | Orthopaedic Surgery | 101 Brookside Drive, Walla Walla, WA 99362 | 2013-10-22 |
| 1023357985 | Sandra Kay Bushnell | Speech-Language Pathologist | 1105 Isaacs Ave, Walla Walla, WA 99362 | 2013-02-12 |
| Find all providers in zip 99362 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912362070 | Ashley Johnson | Pharmacist | 734 Crestview Pl, Walla Walla, WA 99362-4230 | 2015-12-16 |
| 1497853626 | Anh Ngoctuyet Hoang | Pharmacist | 77 Wainwright Dr, Walla Walla, WA 99362-3975 | 2006-09-20 |
| 1407840929 | Kathryn Marie Lewis Koven | Pharmacist | 77 Wainwright Dr, Jm Wainwright Vamc, Walla Walla, WA 99362-3975 | 2005-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649516436 | Andrew James Harbison | Pharmacist | 7080 Killeen Pl Sw, Port Orchard, WA 98367-7617 | 2012-12-24 |
| 1265627640 | Marilyn G Bufton | Pharmacist | 2107 Wilderness Ridge Rd, Bellingham, WA 98229-6901 | 2007-09-10 |
| 1386835817 | Julia Ann Barnett | Pharmacist | 16550 177th Ave Se, Po Box 777, Monroe, WA 98272 | 2007-08-08 |
| 1336356443 | Trent Lawrence Danielson | Pharmacist | 236 2nd Ave N., Okanogan, WA 98840 | 2007-05-17 |
| 1295858934 | Jeffrey B Purcell | Pharmacist | 325 9th Ave Box 359885, Seattle, WA 98104-2499 | 2007-04-09 |
| 1144340654 | Teri Lynn Gilbert | Pharmacist | 713 Canyon View Pl, Yakima, WA 98908-2105 | 2007-03-29 |
| 1386776995 | Edward O. Bye | Pharmacist | 16325 Thorpe Rd Ne, Poulsbo, WA 98370-8010 | 2007-03-09 |
| 1063554954 | Kyle Downey | Pharmacist | 6727 S Moran View St, Spokane, WA 99224-8494 | 2007-02-13 |
| 1447319918 | Steven Harold Erickson | Pharmacist | 24914 153rd Pl Se, Monroe, WA 98272-9558 | 2006-12-08 |
| 1396815155 | Brenda C. Hansen | Pharmacist | 810 S. Main, Deer Park, WA 99006 | 2006-11-09 |
| Find all providers with the same taxonomy | ||||
| City | WALLA WALLA |
| Zip Code | 99362 |
Please comment or provide details below to improve the information on YOUNGTAE KIM.
| 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.