Provider Demographics
NPI:1063730745
Name:KUM, BUP-JONG JENNIFER (MD)
Entity type:Individual
Prefix:
First Name:BUP-JONG
Middle Name:JENNIFER
Last Name:KUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:BUP-JONG
Other - Last Name:KUM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:551 N 34TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8675
Mailing Address - Country:US
Mailing Address - Phone:206-374-9000
Mailing Address - Fax:
Practice Address - Street 1:551 N 34TH ST STE 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8675
Practice Address - Country:US
Practice Address - Phone:206-374-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98913207ZP0102X
IN01067912A207ZP0102X
WA60303530207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology