Youngyun Kim, D.C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5621 Issued in OR

Practice address

4655 SW Griffith Dr
Ste 180
Beaverton, OR 97005-8728

Phone

(253) 227-8900

NPI assigned

Sep 13, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hazel Dell Chiropractic LLC

  • Chiropractor
  • Vancouver, WA
  • NPI 1316643588
  NPD Authorized official
• Hazel Dell Massage LLC

  • Chiropractor
  • Vancouver, WA
  • NPI 1932878006
  NPD Authorized official
• Conerstone Chiropractic PS Inc

  • Clinic/Center
  • Beaverton, OR
  • NPI 1609321157
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1124335070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 SW GRIFFITH DR",
            "address_2": "STE 180",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970058728",
            "telephone_number": "253-227-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 SW GRIFFITH DR",
            "address_2": "STE 180",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970058728",
            "telephone_number": "253-227-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOUNGYUN",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60168065",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Juyun Kim, DDS
• Joshua Kim, D.D.S.
• Kathy S.M. Kim, DDS
• Kyungka Kim
• Woosun Kim, RN
• Ssung J Kimmi, DC
• Madison Kincaid
• Olivia R. Kincaid, MS, SLP-CF
• Kind Mind PDX LLC
• Kindred Mother Care LLC

• Chiropractor in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.