Provider Demographics
NPI:1891997649
Name:KIM, HEWHA (MSW)
Entity Type:Individual
Prefix:MS
First Name:HEWHA
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3633 SE 35TH PL
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-3365
Mailing Address - Country:US
Mailing Address - Phone:503-641-4113
Mailing Address - Fax:503-872-8825
Practice Address - Street 1:3633 SE 35TH PL
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-3365
Practice Address - Country:US
Practice Address - Phone:503-641-4113
Practice Address - Fax:503-872-8825
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health