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General NPI Number Information
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NPI Number | 1124335070
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Entity Type | Individual
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Provider Name | YOUNGYUN KIM D.C
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Gender | Male
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Dates
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Enumeration Date | 09/13/2010
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 4655 SW GRIFFITH DR STE 180
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City | BEAVERTON
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State | OR
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Zip | 97005-8728
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Country | US
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Telephone | 253-227-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 4655 SW GRIFFITH DR STE 180
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City | BEAVERTON
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State | OR
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Zip | 97005-8728
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Country | US
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Telephone | 253-227-8900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH60168065
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5621
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License Number State | OR
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