Kim'S Wellness Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

165166 Issued in OR

Legal business name

KIM'S WELLNESS CENTER

Practice address

917 SW Oak St
Portland, OR 97205

Phone

(917) 456-6385

Fax

(844) 401-8624

NPI assigned

Nov 2, 2015

Organization subpart

No

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

Authorized official

Name

Kimberly Boldrini-Senn, LAC

Title

Owner

Phone

(917) 456-6385

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1548633399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 NE HANCOCK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97212",
            "telephone_number": "917-456-6385",
            "fax_number": "844-401-8624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 SW OAK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "917-456-6385",
            "fax_number": "844-401-8624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM'S WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-02",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "BOLDRINI-SENN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-456-6385",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "165166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Young Jin Kim, RN
• Younghee Kim, DNP
• Yuna Kim
• Yunhee Kim, MD
• Yura Victoria Kim, MA
• Benjamin Kimball
• Ericka Kimball, PHD, LCSW, LISW
• Ethan Kimball, DO
• Sadie Alexandra Kimball
• Terreance Kimber

• Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.