Provider Demographics
NPI:1265831283
Name:COBLYN, MIN KYUNG (PHARM D)
Entity Type:Individual
Prefix:
First Name:MIN KYUNG
Middle Name:
Last Name:COBLYN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 NE 105TH AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97006-7638
Mailing Address - Country:US
Mailing Address - Phone:503-720-8588
Mailing Address - Fax:
Practice Address - Street 1:14625 SW ALLEN BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-3697
Practice Address - Country:US
Practice Address - Phone:503-643-2724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0016489183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist