Individual
SE WON AN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3104 S UNION AVE, TACOMA, WA 98409-3330
(253) 761-3000
Mailing address
1920 100TH ST SE STE C2, EVERETT, WA 98208-3832
(425) 249-0770
(425) 249-0771
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DE61092968
WA
1223G0001X
General Practice Dentistry
Primary
DE61092968
WA
Other
Enumeration date
10/22/2020
Last updated
09/05/2024
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