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NPI Code Detail

MEDICARE: YURA VICTORIA KIM MA

MEDICARE:   YURA VICTORIA KIM  MA
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1417718826
Entity Type Code : Individual
Provider Name (Legal Business Name) : YURA VICTORIA KIM MA
Provider Business Mailing Address
First Line : 1750 SW SKYLINE BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97221-2533
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1750 SW SKYLINE BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97221-2533
Country : US
Telephone Number : 503-894-9630
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2024
Last Update Date : 01/22/2024

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Directions to “ YURA VICTORIA KIM MA” Practice Location

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