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Individual

JOHANAH Y KANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
2013 SOUTH 19TH STREET, TACOMA, WA 98405
(253) 383-3355
(253) 383-3627
Mailing address
2013 SOUTH 19TH STREET, TACOMA, WA 98405
(253) 383-3355
(253) 383-3627

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY60805166
WA
103TC0700X
Clinical Psychologist
PY60805166
WA

Other

Enumeration date
02/08/2018
Last updated
02/08/2018
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