Individual
HYEONGYU KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
5200 MEADOWS RD STE 200, LAKE OSWEGO, OR 97035-0086
(855) 255-1750
(855) 255-0905
Mailing address
413 29TH ST NE STE I, PUYALLUP, WA 98372-7154
(855) 255-1750
(855) 255-0905
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
201602206RN
OR
363L00000X
Nurse Practitioner
Primary
202211907NP-PP
OR
363L00000X
Nurse Practitioner
AP61354264
WA
Other
Enumeration date
09/06/2021
Last updated
09/27/2024
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