Basic Information
Provider Information
NPI: 1477646735
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAIK
FirstName: HUI
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1145 BROADWAY
Address2:  
City: SEATTLE
State: WA
PostalCode: 981224201
CountryCode: US
TelephoneNumber: 2063291760
FaxNumber:  
Practice Location
Address1: 11011 MERIDIAN AVE N
Address2: SUITE 200
City: SEATTLE
State: WA
PostalCode: 981338967
CountryCode: US
TelephoneNumber: 2065255777
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/01/2006
LastUpdateDate: 05/15/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD00040528WAY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
829243505WA MEDICAID


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