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NPI Code Detail

MEDICARE: DR. KEITH CHUNG RPH

MEDICARE: DR. KEITH CHUNG RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPH61421634WA

General Provider Information

NPI Number : 1164204442
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEITH CHUNG RPH
Provider Business Mailing Address
First Line : 2214B 14TH AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98144-4210
Country : US
Telephone Number : 832-800-1368
Fax Number :
Provider Business Practice Location Address
First Line : 3820 RAINIER AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98118-1159
Country : US
Telephone Number : 206-725-9575
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2023
Last Update Date : 10/20/2023

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