Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ML20008969 | WA |
Y | 2080P0202X | Pediatric Cardiologist | MD60147877 | WA |
NPI | 1174713010 |
---|---|
Provider Name | Borah Justina Hong |
First Address | Seattle, WA 98195-0001 |
Second Address | Seattle, WA 98195 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2007 |
Last Update Date | 07/06/2018 |