Healthcare Provider Details

I. General information

NPI: 1669143665
Provider Name (Legal Business Name): NAKYUNG CHOE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LISA CHOE

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9311 SE 36TH ST STE 120
MERCER ISLAND WA
98040-3741
US

IV. Provider business mailing address

9311 SE 36TH ST STE 120
MERCER ISLAND WA
98040-3741
US

V. Phone/Fax

Practice location:
  • Phone: 310-780-8527
  • Fax:
Mailing address:
  • Phone: 310-780-8527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number61208165
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61208165
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number61208165
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: