Provider Demographics
NPI:1710291133
Name:HAM, HEY JEONG (PHARMD)
Entity Type:Individual
Prefix:
First Name:HEY JEONG
Middle Name:
Last Name:HAM
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 1:1620 97TH STREET CT S
Mailing Address - Street 2:# I - 17
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-6653
Mailing Address - Country:US
Mailing Address - Phone:253-617-9896
Mailing Address - Fax:
Practice Address - Street 1:1620 97TH STREET CT S
Practice Address - Street 2:# I - 17
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-6653
Practice Address - Country:US
Practice Address - Phone:253-617-9896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60385229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist