Individual
YONG JIN SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
10009 NE HAZEL DELL AVE, VANCOUVER, WA 98685
(360) 574-3070
Mailing address
527 SE BASELINE ST STE C, HILLSBORO, OR 97123-4149
(503) 648-6054
(503) 648-6099
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9772
WA
1223G0001X
General Practice Dentistry
Primary
D8398
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5050794
—
WA
Enumeration date
03/07/2007
Last updated
01/21/2022
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