Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DE60580376 | WA |
Y | 213EG0000X | General Practice | DE60580376 | WA |
NPI | 1003282997 |
---|---|
Provider Name | Eunsang Michael Cho |
First Address | Shoreline, WA 98133-3162 |
Second Address | Shoreline, WA 98133-3162 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2015 |
Last Update Date | 14/08/2015 |