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General NPI Number Information
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NPI Number | 1023334877
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Entity Type | Individual
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Provider Name | JESSICA SUN WOAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/18/2010
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 1660 S COLUMBIAN WAY, ROOM 6A-102 VETERANS HEALTH ADMINISTRATION PUGET SOUND
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City | SEATTLE
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State | WA
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Zip | 98108
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Country | US
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Telephone | 415-290-2719
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Fax |
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Provider Business Mailing Address
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Address Line | 1141 19TH AVE E
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City | SEATTLE
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State | WA
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Zip | 98112-3504
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Country | US
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Telephone | 415-290-2719
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD60384462
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License Number State | WA
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