Provider Demographics
NPI:1336646744
Name:NAM HOON KIM PC
Entity Type:Organization
Organization Name:NAM HOON KIM PC
Other - Org Name:CENTRO CHIROPRACTIC CLINIC- BEAVERTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-521-5576
Mailing Address - Street 1:11900 SW BEAVERTON HILLSDALE HWY
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-2976
Mailing Address - Country:US
Mailing Address - Phone:971-245-5679
Mailing Address - Fax:971-245-6170
Practice Address - Street 1:11900 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2976
Practice Address - Country:US
Practice Address - Phone:971-245-5679
Practice Address - Fax:971-245-6170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty