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General NPI Number Information
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NPI Number | 1316073661
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Entity Type | Individual
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Provider Name | JINHO KIM MD
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Gender | Male
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 10180 SE SUNNYSIDE RD
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City | CLACKAMAS
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State | OR
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Zip | 97015-8970
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Country | US
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Telephone | 800-813-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 500 NE MULTNOMAH ST STE 100
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City | PORTLAND
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State | OR
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Zip | 97232-2099
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Country | US
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Telephone | 800-813-2000
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 22601
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD20527
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4301059701
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License Number State | OR
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