Individual
VIRGIL KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14090 FRYELANDS BLVD SE STE 347, MONROE, WA 98272-2760
(360) 805-3122
(360) 805-9180
Mailing address
14090 FRYELANDS BLVD SE STE 347, MONROE, WA 98272-2760
(360) 805-3122
(360) 805-9180
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
60795326
WA
106H00000X
Marriage & Family Therapist
Primary
MG60172608
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881996551
—
WA
Enumeration date
12/01/2010
Last updated
06/16/2018
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