MR. KWANG IL KIM (NPI# 1063994721) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063994721 |
| Entity Type | Individual |
| Full Name | MR. KWANG IL KIM |
| Credential | MSW |
| Practice Address |
322 Nw 5th Ave Ste 301b Portland OR 97209-3828 |
| Mailing Address |
Po Box 1866 Vancouver WA 98668-1866 |
| Practice Telephone | 5034320333 |
| Mailing Telephone | 5034320333 |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
A2995 | OR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OREGON BOARD OF LICENSED SOCIAL WORKERS | A2995 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871122812 | Kwang Kim | Student in an Organized Health Care Education/Training Program | 16201 Northern Blvd # 790, Flushing, NY 11358-1634 | 2020-04-02 |
| 1578956579 | Kwang Soo Kim | Radiology | 6475 N Tower Ct, Lincolnwood, IL 60712-4207 | 2015-03-15 |
| 1881901619 | Kwang Jib Kim | Dentist | 594 N. Indian Hill Blvd., Pomona, CA 91767-5302 | 2010-08-31 |
| 1417183047 | Kwang Cho Kim | Psychiatry & Neurology | 3745 Charter Pl, Ann Arbor, MI 48105-2826 | 2009-06-10 |
| 1205074838 | Kwang Han Kim | Dentist | 39150 Sundale Dr, Apt #102, Fremont, CA 94538-2068 | 2009-02-04 |
| 1861656498 | Kwang Kim | Pharmacist | 7350 N Kilbourn Ave, Lincolnwood, IL 60712-1809 | 2008-07-13 |
| 1003035114 | Kwang Seob Kim | Dentist | 18250 Colima Rd, 201, Rowland Heights, CA 91748-2602 | 2007-04-25 |
| 1578611356 | Kwang Jin Kim | Dentist | 3300 W Rosecrans Ave, Suite 105, Hawthorne, CA 90250-8218 | 2007-01-08 |
| 1356437842 | Kwang Hyun Kim | Dentist | 670 Las Gallinas Ave, San Rafael, CA 94903-3687 | 2006-10-04 |
| 1285725051 | Kwang Sook Kim | General Practice | 9636 Garden Grove Blvd # 16, Garden Grove, CA 92844-1530 | 2006-09-27 |
| Street Address |
322 NW 5TH AVE STE 301B |
| City | PORTLAND |
| State | OR |
| Zip Code | 97209-3828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1619599636 | Rivers Way Training Clinic | Community/Behavioral Health | 2049 Nw Hoyt, Portland, OR 97209 | 2020-05-13 |
| 1518590538 | Julie Kay Igarta | Registered Nurse | 140 Northwest 14th Avenue, Portland, OR 97209 | 2020-02-18 |
| 1407492002 | Oregon Injection Clinic | Clinic/Center | 1500 Nw Lovejoy, 106, Portland, OR 97209 | 2019-11-19 |
| 1487202883 | Ann Tesora | Massage Therapist | 1320 Northwest 20th Avenue, Portland, OR 97209 | 2019-08-28 |
| 1972160455 | Vincent Martin | Massage Therapist | 210 Sw 17th Avenue, Portland, OR 97209 | 2019-05-21 |
| 1154896546 | Jennifer Marie Dodd | Social Worker | 1722 Nw Raleigh St Spc 412, Portland, OR 97209 | 2018-10-11 |
| 1922551910 | Ashley Crowell | Physician Assistant | 949 Nw Overton St Unit 306, Portland, OR 97209 | 2016-07-26 |
| 1326408394 | Jennifer Blain | Counselor | 324 Nw Davis, Portland, OR 97209 | 2016-03-03 |
| 1275993255 | Lauren Dodson | Licensed Practical Nurse | 324 Nw Davis St, Portland, OR 97209 | 2016-03-03 |
| Find all providers in zip 97209 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748243 | Jessica M Feinsmith | Counselor | 6530 N Williams Ave, Portland, OR 97217-1924 | 2020-10-21 |
| 1720687809 | Karissa Myriah Gregory | Counselor | 14255 Se Rupert Dr, Portland, OR 97267-1211 | 2020-10-20 |
| 1528667904 | Zuzana Sakova | Counselor | 819 Se Morrison St Ste 225, Portland, OR 97214-6311 | 2020-10-18 |
| 1891302238 | Nina Landey | Counselor | 120 Se 53rd Ave, Portland, OR 97215-1204 | 2020-09-29 |
| 1902412166 | Peter H Addy LLC | Counselor | 524 N Tillamook St Ste 102b, Portland, OR 97227-1993 | 2020-09-22 |
| 1326654765 | Naomi Painter | Counselor | 1925 Ne 19th Ave Apt 8a, Portland, OR 97212-4526 | 2020-09-21 |
| 1750996104 | Sara Fuller | Counselor | 3016 Ne 70th Ave, Portland, OR 97213-5802 | 2020-09-12 |
| 1114532983 | Matthew W Cronin | Counselor | 1122 Ne 122nd Ave Ste 200, Portland, OR 97230-2081 | 2020-09-09 |
| 1447865381 | Luke Colbourn | Counselor | 2705 E Burnside St Ste 206, Portland, OR 97214-1768 | 2020-09-08 |
| 1710599774 | Abigail Kathryn Ernst | Counselor | 1020 Sw Taylor St # 100, Portland, OR 97205-2543 | 2020-08-20 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.