Kim, Youngtae

Kim, Youngtae is an individual health care provider with primary practice located at 401 W Poplar St , Walla Walla WA 99362-2846. He recently has only one registered license in Pharmacy Service Providers / Pharmacotherapy, which is considered as his primary health care specialty. Kim, Youngtae can be contacted via phone (503) 519-4302.

Contact Information

Primary practice address
401 W Poplar St Walla Walla WA 99362-2846
Phone: (503) 519-4302
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacotherapy 1835P1200X PH60781611 Washington

Profile Details

NPI number 1609374867
LBN Legal business name Kim, Youngtae
Credentials PHARMD, MBA
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2018
Last updated Jan 23rd, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609374867 NPPES
Washington Other PH60781611 PHAMACIST LICENSE

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