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Individual

KEVIN Y SONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
751 NE BLAKELY DR STE 3020, ISSAQUAH, WA 98029-6201
(425) 313-5345
(425) 313-4704
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD61409484
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2259592
WA
Enumeration date
04/27/2016
Last updated
10/03/2023
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