Healthcare Provider Details

I. General information

NPI: 1558491720
Provider Name (Legal Business Name): JUNGSUN HUH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 MERIDIAN E STE 23
MILTON WA
98354-7003
US

IV. Provider business mailing address

1802 49TH STREET CT NW
GIG HARBOR WA
98335-2421
US

V. Phone/Fax

Practice location:
  • Phone: 253-925-2680
  • Fax:
Mailing address:
  • Phone: 253-224-6666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number61280
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: