Individual
JEAN M. KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
500 W. FORT ST, CRH, 2ND FLOOR, BOISE, ID 83702-4501
(208) 422-1018
Mailing address
1660 S. COLUMBIAN WAY, S-116-MHC, SEATTLE, WA 98108-1597
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
PY60847665
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2015
Last updated
10/01/2024
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