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Deactivated NPI 1114694874 Deactivated / Inactive NPI Female Practitioner

Jisu Kim

Case Manager/Care Coordinator • Seattle, WA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jisu Kim has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 30, 2021
NPI Deactivation Date September 25, 2025
Total Practice Duration ~4 Years of Practice (2021 – 2025)

Professional Overview & Biography Verified Profile Summary

Jisu Kim was a registered Case Manager/Care Coordinator practicing in Seattle, WA. Throughout an active medical career spanning 4 years, Jisu Kim provided care at the practice location at 1902 2ND AVE until profile deactivation on 2025-09-25.

Practice Location & Contact Primary Location

Practice Address

1902 2nd Ave

Seattle, WA 981011155

Telephone 2069569570

Specialty Benchmarks & Practice Insights

Comparative analytics for Case Manager/Care Coordinator in Seattle, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 8.5 Yrs
Regional Practice Density
397 Specialists

Practicing in Seattle, WA (2132 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Case Manager/Care Coordinator Primary Specialty

NUCC Taxonomy Code: 171M00000X

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Tracey Mofidi

Counselor

NPI 1033659560
Rachel Lough

Student in an Organized Health Care Education/Training Program

NPI 1053167858
Anna Lewi

Counselor

NPI 1063079713
Cecilie Wilhelm , MHP

Counselor - Mental Health

NPI 1083268072

Mental Health Practitioner

Ma Rita Manalastas

Student in an Organized Health Care Education/Training Program

NPI 1104431501
Allyson Mcdonough , BA

Counselor - Mental Health

NPI 1114445269

Bachelor of Arts

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 25, 2025

Record deactivated on September 25, 2025

NPI Profile Active August 30, 2021

NPI status registered as active in NPPES database

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Updated Practice Location August 30, 2021

Registered at 1902 2ND AVE, SEATTLE, WA 981011155 (Tel: 2069569570)

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Updated Business Mailing Address August 30, 2021

Registered at 1902 2ND AVE, SEATTLE, WA 981011155 (Tel: 2069569570)

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Provider Name / Credentials Updated August 30, 2021

Recorded as JISU KIM

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 30, 2021

Case Manager/Care Coordinator

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Initial NPI Registration & Enumeration August 30, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114694874
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 30, 2021
Last Update: August 30, 2021
Deactivation Date: September 25, 2025

Mailing Address

1902 2nd Ave

Seattle, WA 981011155

Phone: 2069569570

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.