Individual
ELLEN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-5000
Mailing address
6550 GLADEVIEW CT, BURKE, VA 22015-4113
(703) 347-1440
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MA
Other
Enumeration date
04/08/2026
Last updated
04/08/2026
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