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Individual

TABITHA KU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2730
(360) 414-2739
Mailing address
SPECIALTY CLINIC - PULMONOLOGY/PULMONARY MEDICINE, 1615 DELAWARE STREET, LONGVIEW, WA 98632
(310) 414-2730

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-39947
KS
207R00000X
Internal Medicine Physician
2014021210
MO
207R00000X
Internal Medicine Physician
MD61002866
WA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
04-39947
KS
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD61002866
WA
207RP1001X
Pulmonary Disease Physician
04-39947
KS
207RP1001X
Pulmonary Disease Physician
Primary
MD61002866
WA

Other

Enumeration date
06/30/2014
Last updated
06/17/2020
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