Individual
JUNYEON PAUL KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW/QMHP
Contact information
Practice address
2355 STATE ST STE 101, SALEM, OR 97301-4541
(803) 360-7783
(971) 251-1933
Mailing address
3439 NE SANDY BLVD # 646, PORTLAND, OR 97232-1959
(803) 360-7783
(971) 251-1933
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
OR
104100000X
Social Worker
A5807
OR
1041C0700X
Clinical Social Worker
Primary
L11257
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500734777
—
OR
Enumeration date
07/10/2015
Last updated
02/16/2023
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