Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Khamphoucanh Southisombath, MD

Individual provider Family Medicine Physician · NPI 1114316734

Khamphoucanh Southisombath, MD is a Family Practice in Federal Way, Washington. Graduated from University of California, San Diego School of Medicine in 2013, 13 years ago. Practices with The Association of University Physicians, a 3,459-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
13
Trained at
University of California, San Diego School of Medicine
Licensed in
WA
In the registry since
2015
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

32018 23rd Ave S
Federal Way, WA 98003-6022
Phone: (206) 520-5000
Fax: (206) 520-1799
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD60658344 (WA)

Record details

NPI number1114316734
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 20, 2015
Last updated in NPPESJuly 17, 2025
Certification dateJuly 17, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Graduated 2013 (13 years in practice)
Group practice The Association Of University Physicians — 3459 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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