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Chan Sun Hwang
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NPI Number Detailed Information
Provider Information:
| Name: | Chan Sun Hwang |
| Gender: | M |
| Provider License Number If Given: | MD00035834 |
NPI Information:
| NPI: | 1861486367 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 9/12/2005 |
| Last Update Date: | 11/17/2017 |
Provider Business Mailing Address:
| Address: | 6820 WATER ST NE Tacoma, WA 98422 |
| Phone Number: | 2537323564 |
| Fax Number: | 8774251425 |
Provider Business Practice Location Address:
| Address: | 9312 S TACOMA WAY STE 115 Lakewood, WA 98499 |
| Phone Number: | 2532512551 |
| Fax Number: | 2532513197 |
Provider Taxonomy:
| Primary: | 2081P2900X |
| Secondary (if any): | 2081N0008X |
| State: | WA |
