Individual
JACKY JAEOK KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
235 W 10TH AVE, EUGENE, OR 97401-3008
(541) 515-7800
Mailing address
2620 BELLEVUE WAY NE # 234, BELLEVUE, WA 98004-2209
(504) 982-4909
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
24-QMHP-R-3205
OR
1041C0700X
Clinical Social Worker
L17503
OR
1041C0700X
Clinical Social Worker
Primary
SC61561577
WA
Other
Enumeration date
10/22/2024
Last updated
01/19/2026
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