Provider Demographics
NPI:1013379221
Name:AHN, HAEJUN CECILIA (MD)
Entity Type:Individual
Prefix:
First Name:HAEJUN
Middle Name:CECILIA
Last Name:AHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 25608
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0608
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:751 NE BLAKELY DR STE 5010
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-6201
Practice Address - Country:US
Practice Address - Phone:425-313-7088
Practice Address - Fax:425-394-0757
Is Sole Proprietor?:No
Enumeration Date:2016-03-26
Last Update Date:2023-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD614571622080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology