Individual
ANNIE KYUNGA AHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4033 TALBOT RD S STE 540, RENTON, WA 98055
(425) 690-3602
(425) 690-9602
Mailing address
3600 LIND AVE SW, SUITE 100 ATTN CREDENTIALING, RENTON, WA 98057-4970
(425) 690-2715
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD60943971
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2139652
—
WA
01
—
G9000068
MEDICARE W VALLEY MEDICAL GROUP - RENTON
—
Enumeration date
03/24/2014
Last updated
05/05/2021
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