Individual
EDWARD KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12005 SW 70TH AVE, TIGARD, OR 97223-9634
(503) 208-3579
Mailing address
12905 SW WILMINGTON LN, TIGARD, OR 97224-1794
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6301
OR
Other
Enumeration date
04/10/2023
Last updated
12/17/2025
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