Doctor Name: | SUNG YE PAK |
NPI Number: | 1467682906 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP |
License Number: | MA00023361 |
Business Practice Address: | 7521 Bridgeport Way W Suite B Lakewood, WA - 984992423 |
Business Phone Number: | 2532416798 |
Business Fax Number: | |
Mailing Address: | Po Box 88021, STEILACOOM |
State: | WA |
Postal Code: | 983880021 |
Phone Number: | 2534594371 |
Fax Number: | |
NPI Enumeration Date: | 07/17/2009 |
NPI Last Update Date: | 07/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA00023361 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |