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General NPI Number Information
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NPI Number | 1639189004
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Entity Type | Organization
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Legal Business Name | EUN K KWON WASHINGTON HEALTH CARE
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 2525 87TH AVE W # 13-138 2525 87TH AVE W # 13-138
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-1821
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Country | US
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Telephone | 253-582-3094
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Fax |
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Provider Business Mailing Address
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Address Line | 2525 87TH AVE W # 13-138
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-1821
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Country | US
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Telephone | 253-582-3094
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EUN KYUNG KWON
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Credential |
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Telephone | 253-582-3094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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