Provider Demographics
NPI:1124335070
Name:KIM, YOUNGYUN (DC)
Entity type:Individual
Prefix:DR
First Name:YOUNGYUN
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4655 SW GRIFFITH DR
Mailing Address - Street 2:STE 180
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-8728
Mailing Address - Country:US
Mailing Address - Phone:253-227-8900
Mailing Address - Fax:
Practice Address - Street 1:4655 SW GRIFFITH DR
Practice Address - Street 2:STE 180
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-8728
Practice Address - Country:US
Practice Address - Phone:253-227-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60168065111N00000X
OR5621111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor