Healthcare Provider Details

I. General information

NPI: 1326036690
Provider Name (Legal Business Name): RICHARD KWUN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 04/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18100 NE UNION HILL RD SUITE 200
REDMOND WA
98052-3330
US

IV. Provider business mailing address

PO BOX 25608
SALT LAKE CITY UT
84125-0608
US

V. Phone/Fax

Practice location:
  • Phone: 206-320-5190
  • Fax: 206-320-5191
Mailing address:
  • Phone: 206-320-4476
  • Fax: 206-568-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number11542
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: