Provider Demographics
NPI:1346367810
Name:OH, EUNJUNG (PHARMD)
Entity Type:Individual
Prefix:
First Name:EUNJUNG
Middle Name:
Last Name:OH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7627 27TH ST W
Mailing Address - Street 2:APT C29
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4147
Mailing Address - Country:US
Mailing Address - Phone:253-209-7096
Mailing Address - Fax:
Practice Address - Street 1:1850 S MILDRED ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98465-1608
Practice Address - Country:US
Practice Address - Phone:253-460-9599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00057311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist