Individual
KUNTHEARITH SIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11907 LAKESIDE PL NE, SEATTLE, WA 98125-5954
(206) 550-5067
Mailing address
11907 LAKESIDE PL NE, SEATTLE, WA 98125-5954
(206) 550-5067
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
12659
NV
207R00000X
Internal Medicine Physician
Primary
MD2007-0115
NM
Other
Enumeration date
02/06/2007
Last updated
09/12/2008
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