Provider Demographics
NPI:1396904173
Name:KOH, MAHNSOON (RPH)
Entity type:Individual
Prefix:MS
First Name:MAHNSOON
Middle Name:
Last Name:KOH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:SOONIE
Other - Middle Name:
Other - Last Name:KOH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:2713 151ST PL SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-2457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2713 151ST PL SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-2457
Practice Address - Country:US
Practice Address - Phone:425-341-3004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA41671183500000X
WAPH00041671183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist