Individual
MRS. KALIS J KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
501 SE 172ND AVE, VANCOUVER, WA 98684-9542
(360) 882-2778
Mailing address
PO BOX 4825, PORTLAND, OR 97208-4825
(360) 882-2778
(360) 604-1771
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP60976791
WA
Other
Enumeration date
08/15/2019
Last updated
10/01/2019
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