Individual
SE JUNG SHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10555 SE CARR RD BLDG M, RENTON, WA 98055-5820
(425) 656-4270
(425) 656-4271
Mailing address
3600 LIND AVE SW, RENTON, WA 98057-4934
(425) 228-3440
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00038373
WA
207P00000X
Emergency Medicine Physician
MD22180
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130308
—
OR
05
—
2065309
—
WA
01
—
G8959946
MEDICARE
WA
Enumeration date
01/27/2006
Last updated
04/30/2018
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