Individual
FREDRICK SUNGJAE AN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
413 LILLY RD NE, OLYMPIA, WA 98506-5166
(360) 491-9480
(360) 456-2413
Mailing address
413 LILLY RD NE, OLYMPIA, WA 98506-5166
(360) 491-9480
(360) 456-2413
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
DO29350
OR
207R00000X
Internal Medicine Physician
Primary
OP61580368
WA
208M00000X
Hospitalist Physician
OP61580368
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2013154
—
WA
Enumeration date
05/01/2008
Last updated
03/19/2025
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