Provider Demographics
NPI:1780823831
Name:KIM, JOOYONG V (RPH)
Entity Type:Individual
Prefix:MS
First Name:JOOYONG
Middle Name:V
Last Name:KIM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-2346
Mailing Address - Country:US
Mailing Address - Phone:425-339-9448
Mailing Address - Fax:
Practice Address - Street 1:3333 164TH ST SW APT 1011
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-3157
Practice Address - Country:US
Practice Address - Phone:425-478-0982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60060459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist