Individual
MR. SIK KIYOSHI KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-4278
Mailing address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-4278
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD22289
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130253
—
OR
Enumeration date
04/04/2006
Last updated
04/27/2012
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