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Individual

TRACEY KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
665 WINTER ST SE, SALEM, OR 97301-3934
(503) 561-2448
Mailing address
665 WINTER ST SE, SALEM, OR 97301-3934
(818) 521-2237

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
223280
OR
2086S0102X
Surgical Critical Care Physician
223280
OR
2086S0127X
Trauma Surgery Physician
Primary
223280
OR

Other

Enumeration date
04/18/2015
Last updated
04/22/2025
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