Individual
JOHNNY Y SHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4540 UNION BAY PL NE, SEATTLE, WA 98105-4025
(206) 320-3400
(206) 320-5773
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP60384423
WA
208M00000X
Hospitalist Physician
OP60384423
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407140056
—
WA
05
—
2020728
—
WA
01
—
G8930498
MEDICARE W VALLEY MEDICAL GROUP - RENTON
WA
Enumeration date
05/31/2011
Last updated
01/18/2022
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