Individual
MR. JAKE T KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
7320 216TH ST SW, SUITE 200, EDMONDS, WA 98026-8006
(425) 640-4900
(425) 640-4919
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
081733
NY
1041C0700X
Clinical Social Worker
Primary
LW60218364
WA
Other
Enumeration date
08/09/2010
Last updated
07/10/2015
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