OHTAE KWON

TACOMA, WA
NPI1770187627
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: TX  1018225)
Enumeration Date2020-11-22
Last Update Date2022-02-02
Business Address
OHTAE KWON PMHNP
5909 ORCHARD ST W
TACOMA, WA 98467-3824
Phone number: 253-475-6021
Mailing Address
OHTAE KWON PMHNP
5909 ORCHARD ST W
TACOMA, WA 98467-3824
Phone number: 253-475-6021
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