Healthcare Provider Details
I. General information
NPI: 1093866170
Provider Name (Legal Business Name): YUN SUN CHOE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/15/2007
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
209 MARTIN LUTHER KING JR WAY
TACOMA WA
98405-4265
US
IV. Provider business mailing address
209 MARTIN LUTHER KING JR WAY TACOMA MEDICAL CENTER
TACOMA WA
98405-4265
US
V. Phone/Fax
- Phone: 253-596-3300
- Fax:
- Phone: 253-596-3300
- Fax: 253-596-3301
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0000X |
| Taxonomy | Adolescent Medicine (Internal Medicine) Physician |
| License Number | MD00036687 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | MD00036687 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: