Provider Demographics
NPI:1558491720
Name:HUH, JUNGSUN
Entity Type:Individual
Prefix:
First Name:JUNGSUN
Middle Name:
Last Name:HUH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 49TH STREET CT NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-2421
Mailing Address - Country:US
Mailing Address - Phone:253-224-6666
Mailing Address - Fax:
Practice Address - Street 1:900 MERIDIAN E STE 23
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:WA
Practice Address - Zip Code:98354-7003
Practice Address - Country:US
Practice Address - Phone:253-925-2680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist