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1770187627
OHTAE KWON
TACOMA, WA
NPI
1770187627
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner Psychiatric/Mental Health
(Licence: TX 1018225)
Enumeration Date
2020-11-22
Last Update Date
2022-02-02
Business Address
OHTAE KWON PMHNP
5909 ORCHARD ST W
TACOMA, WA 98467-3824
Phone number: 253-475-6021
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Mailing Address
OHTAE KWON PMHNP
5909 ORCHARD ST W
TACOMA, WA 98467-3824
Phone number: 253-475-6021
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