Individual
CINDY KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
304 NE HOOD AVE, GRESHAM, OR 97030-7450
(503) 666-1333
Mailing address
304 NE HOOD AVE, GRESHAM, OR 97030-7450
(503) 666-1333
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
63430
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63430
STATE LICENSURE
OR
Enumeration date
04/29/2021
Last updated
04/29/2021
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