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General NPI Number Information
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NPI Number | 1699064360
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Entity Type | Organization
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Legal Business Name | HSU KIM AND GHORBANIAN PLLC
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 04/04/2011
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Provider Practice Location Address
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Address Line | 1258 W WASHINGTON ST #303
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City | SEQUIM
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State | WA
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Zip | 98382-3227
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Country | US
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Telephone | 360-797-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 1258 W WASHINGTON ST #303
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City | SEQUIM
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State | WA
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Zip | 98382-3227
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Country | US
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Telephone | 360-797-1100
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Fax |
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Authorized Official
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Title or Position | ACCOUNTANT
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Name | KAREN CROUSE
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Credential | CPA
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Telephone | 360-457-3303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 10147
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License Number State | WA
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