Individual
DR. JOON KYUNG SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1304 FAWCETT AVE STE 100, TACOMA, WA 98402-1900
(253) 761-4200
(253) 761-4201
Mailing address
PO BOX 1535, TACOMA, WA 98401-1535
(253) 761-4200
(253) 383-3553
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
MD00034694
WA
2085N0700X
Neuroradiology Physician
MD162209
OR
2085R0202X
Diagnostic Radiology Physician
Primary
MD00034694
WA
2085R0202X
Diagnostic Radiology Physician
MD162209
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0236611
LABOR AND INDUSTRIES-TRA
WA
01
—
0236614
LABOR AND INDUSTRIES-UNION AVENUE OPEN MRI
WA
05
—
1092213
—
WA
05
—
500671175
—
OR
01
—
8947494
LABOR AND INDUSTRIES CRIME VICTIMS-TRA
WA
01
—
8947866
LABOR AND INDUSTRIES CRIME VICTIMS-UNION AVENUE OPEN MRI
WA
Enumeration date
11/09/2005
Last updated
08/30/2024
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