Individual
SSUNG J KIMMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
12795 SW 3RD ST., BEAVERTON, OR 97005
(503) 641-4244
(503) 641-0551
Mailing address
12795 SW 3RD ST., BEAVERTON, OR 97005
(503) 641-4244
(503) 641-0551
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
273444
OR
111N00000X
Chiropractor
Primary
3444
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
858521000
HEALTH INSURANCE PROVIDER
OR
Enumeration date
03/28/2007
Last updated
12/08/2011
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