Basic Information
Provider Information
NPI: 1093866170
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHOE
FirstName: YUN
MiddleName: SUN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 209 MARTIN LUTHER KING JR WAY
Address2: TACOMA MEDICAL CENTER
City: TACOMA
State: WA
PostalCode: 984054265
CountryCode: US
TelephoneNumber: 2535963300
FaxNumber: 2535963301
Practice Location
Address1: 209 MARTIN LUTHER KING JR WAY
Address2:  
City: TACOMA
State: WA
PostalCode: 984054265
CountryCode: US
TelephoneNumber: 2535963300
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/15/2007
LastUpdateDate: 03/31/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RA0000XMD00036687WAN Allopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
207RR0500XMD00036687WAY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

ID Information
IDTypeStateIssuerDescription
823503805WA MEDICAID
12618501WAL&I NUMBEROTHER


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