Individual
MS. SOONIE ANN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
5200 SW MACADAM AVE, #580, PORTLAND, OR 97239-6103
(503) 231-7854
(503) 231-8153
Mailing address
5200 SW MACADAM AVE, #580, PORTLAND, OR 97239-6103
(503) 231-7854
(503) 231-8153
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1175
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158831
—
OR
Enumeration date
04/10/2006
Last updated
10/01/2008
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