Healthcare Provider Details

I. General information

NPI: 1689390908
Provider Name (Legal Business Name): YOON & LIM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 H ST
BLAINE WA
98230-4110
US

IV. Provider business mailing address

432 H ST
BLAINE WA
98230-4110
US

V. Phone/Fax

Practice location:
  • Phone: 360-332-8737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: JONG YOON
Title or Position: OWNER
Credential:
Phone: 415-713-0434