Provider Demographics
NPI:1164820148
Name:KIM, NAM HOON (DC)
Entity Type:Individual
Prefix:MR
First Name:NAM
Middle Name:HOON
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 1:12535 SE 131ST CT
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-1684
Mailing Address - Country:US
Mailing Address - Phone:360-521-5576
Mailing Address - Fax:833-517-1922
Practice Address - Street 1:18206 SE STARK ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-4863
Practice Address - Country:US
Practice Address - Phone:360-521-5676
Practice Address - Fax:833-517-1922
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-08
Last Update Date:2024-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60514800111N00000X
OR5599111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor