Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | MD23590 | OR |
NPI | 1043207871 |
---|---|
Provider Name | Dr. Jin-Hee Kim |
First Address | Portland, OR 97232-2684 |
Second Address | Portland, OR 97216-2448 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2005 |
Last Update Date | 02/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
286526 | (05) | OR |
8383135 | (05) | WA |
H60853 | (02) |