Individual
STEPHANIE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3016 NE BROADWAY ST, PORTLAND, OR 97232-1811
(503) 287-6636
Mailing address
3016 NE BROADWAY ST, PORTLAND, OR 97232-1811
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/11/2018
Last updated
09/15/2023
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