Provider Demographics
NPI:1770906877
Name:MANN, YUN SUK (NAC)
Entity type:Individual
Prefix:
First Name:YUN
Middle Name:SUK
Last Name:MANN
Suffix:
Gender:F
Credentials:NAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 150TH ST S
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-9019
Mailing Address - Country:US
Mailing Address - Phone:253-536-2297
Mailing Address - Fax:253-536-2297
Practice Address - Street 1:1802 150TH ST S
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-9019
Practice Address - Country:US
Practice Address - Phone:253-536-2297
Practice Address - Fax:253-536-2297
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA524101311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home