Kim, Soonie Ann

Kim, Soonie Ann is an individual health care provider with primary practice located at 5200 Sw Macadam Ave #580, Portland OR 97239-6103. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Kim, Soonie Ann can be contacted via phone (503) 231-7854.

Contact Information

Primary practice address
5200 Sw Macadam Ave #580 Portland OR 97239-6103
Fax: (503) 231-8153
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1175 Oregon

Profile Details

NPI number 1063475259
LBN Legal business name Kim, Soonie Ann
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Oct 1st, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063475259 NPPES
Oregon MEDICAID 158831

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