Individual provider · Type 1 NPI

Jacky Jaeok Kim

Clinical Social Worker · Eugene, OR

NPI number 1790506665 Active

Practice location

235 W 10th Ave
Eugene, OR 97401-3008

Mailing address

2620 Bellevue Way NE # 234
Bellevue, WA 98004-2209

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XSWI.LW.70016961 (WA)
Clinical Social Worker 1041C0700XL17503 (OR)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1790506665

Jacky Jaeok Kim's National Provider Identifier is 1790506665, issued on Oct 22, 2024. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Eugene, OR. The record was last updated on Jun 23, 2026.