Individual ProviderLeonid KimInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1321 Colby Ave, Everett, WA 98201-1665(425) 261-2000(866) 747-2455PECOS EnrollmentBased on the most recent information from CMS, provider Leonid Kim is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1407116874Provider TypeIndividualFull NameKim, LeonidTitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date5/20/2012Last Updated3/29/2021Contact InformationPractice LocationPractice Address1321 Colby Ave, Everett, WA 98201-1665Phone(425) 261-2000FaxUnlisted FaxMailing LocationMailing AddressPO Box 3360, Portland, OR 97208-3360Phone(866) 747-2455FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseMD60543508WashingtonCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense183060North CarolinaCode208M00000XDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicenseMD60543508Washington