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
Phone: (503) 231-7854
Fax: (503) 231-8153
Website:
Health care specialties
| Specialty | Code | License # | 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 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063475259 | NPPES |
| Oregon | MEDICAID | 158831 |
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