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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609374867 | NPPES |
| Washington | Other | PH60781611 | PHAMACIST LICENSE |
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