Provider Demographics
NPI:1043474489
Name:WELU HEALTHCARE INC
Entity Type:Organization
Organization Name:WELU HEALTHCARE INC
Other - Org Name:HIGHLAND PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YONGJOO
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIM
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:253-839-1399
Mailing Address - Street 1:31840 PACIFIC HWY S
Mailing Address - Street 2:STE A-2
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5450
Mailing Address - Country:US
Mailing Address - Phone:253-839-1399
Mailing Address - Fax:253-839-1477
Practice Address - Street 1:31840 PACIFIC HWY S
Practice Address - Street 2:STE A-2
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5450
Practice Address - Country:US
Practice Address - Phone:253-839-1399
Practice Address - Fax:253-839-1477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
WA602393383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2132236OtherPK
WA1043474489Medicaid
6697480001Medicare NSC