Individual ProviderNam Su KimMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1627 S 312th St Unit B, Federal Way, WA 98003-4915(253) 839-9330PECOS EnrollmentBased on the most recent information from CMS, provider Nam Su Kim does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1750820015Provider TypeIndividualFull NameKim, Nam SuGenderMaleSole ProprietorYesEnumeration Date2/20/2017Last Updated2/20/2017Contact InformationPractice LocationPractice Address1627 S 312th St Unit B, Federal Way, WA 98003-4915Phone(253) 839-9330Fax(425) 644-6067Mailing LocationMailing Address1627 S 312th St Unit B, Federal Way, WA 98003-4915Phone(253) 839-9330Fax(425) 644-6067Provider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA60726687Washington