Individual
DR. JI YOUNG NAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
747 BROADWAY, SEATTLE, WA 98122-4379
(206) 215-2520
(206) 386-3180
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD452121
PA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD60675938
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2011
Last updated
08/26/2016
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