MEDICARE: MS. JIWON KIM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	M05966	MD

General Provider Information

NPI Number	:	1730071366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JIWON KIM

Provider Business Mailing Address
First Line	:	9050 DUMHART RD
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20723-1200
Country	:	US
Telephone Number	:	443-979-0551
Fax Number	:

Provider Business Practice Location Address
First Line	:	3448 ELLICOTT CENTER DR
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-4171
Country	:	US
Telephone Number	:	443-996-1100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2025
Last Update Date	:	07/17/2025

Similar Medicare Providers

1770502783 — DR. ROBERT DALE WARMAN D.D.S.
Practice Location Address:

3448 ELLICOTT CENTER DR , SUITE 105
ELLICOTT CITY, MD
21043-4171

Practice Phone: 410-418-8485
Practice Fax:

1598147829 — SHARON MURPHY, M.D. L.L.C.
Practice Location Address:

3448 ELLICOTT CENTER DR , SUITE 102
ELLICOTT CITY, MD
21043-4171

Practice Phone: 410-772-0255
Practice Fax: 410-772-0243

1154044774 — KITT LENA KLASSEN LGPC
Practice Location Address:

3448 ELLICOTT CENTER DR
ELLICOTT CITY, MD
21043-4171

Practice Phone: 202-731-0811
Practice Fax:

1558746503 — MARIETTE ADCOCK LOVINGER
Practice Location Address:

4171 COUNTY ROAD 240
KINGDOM CITY, MO
65262-1111

Practice Phone: 573-642-4333
Practice Fax:

1891484127 — RAND COUNSELING AND WELLNESS LLC
Practice Location Address:

4171 S MARQUIS WAY
SALT LAKE CITY, UT
84124

Practice Phone: 267-225-0257
Practice Fax:

1649042144 — MRS. MEGAN ELIZABETH VANDEWALKER MA, CCC-SLP
Practice Location Address:

4171 COUNTY ROAD 240
KINGDOM CITY, MO
65262-1111

Practice Phone: 573-642-4333
Practice Fax:

Directions to “ MS. JIWON KIM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.