Basic Information
| Provider Information | |||||||||
| NPI: | 1023218047 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAIK | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11301 NE 7TH ST | ||||||||
| Address2: | APT F8 | ||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986845113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094355044 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 100 E 33RD ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986632776 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605147550 | ||||||||
| FaxNumber: | 3605147553 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2007 | ||||||||
| LastUpdateDate: | 07/07/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ML20008770 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.