Bridgeport Medical Clinic PLLC
NPI 1982855995ActiveOrganization· Clinic/Center· Puyallup, WA
Clinic/Center in Puyallup, Washington, registered in NPPES in October 2008. The authorized official on file is Dennis Jooyoung Kim, M.D., Member. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1982855995 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 8, 2008 |
| Last updated in NPPES | May 3, 2023 |
| Certified by provider | May 3, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X | MD00041157 | WA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (WA) |
|---|
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