Healthcare Provider Details

I. General information

NPI: 1346367810
Provider Name (Legal Business Name): EUNJUNG OH PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 S MILDRED ST
TACOMA WA
98465-1608
US

IV. Provider business mailing address

7627 27TH ST W APT C29
UNIVERSITY PLACE WA
98466-4147
US

V. Phone/Fax

Practice location:
  • Phone: 253-460-9599
  • Fax:
Mailing address:
  • Phone: 253-209-7096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00057311
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: