Individual
SU YIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1235 SE DIVISION ST STE 104, PORTLAND, OR 97202-1055
(503) 313-4220
Mailing address
1235 SE DIVISION ST STE 104, PORTLAND, OR 97202-1055
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L6461
OR
Other
Enumeration date
09/28/2012
Last updated
08/20/2015
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