Provider Demographics
NPI:1699293688
Name:CHOE, JIN MAN
Entity type:Individual
Prefix:
First Name:JIN
Middle Name:MAN
Last Name:CHOE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15720 E 4TH AVE APT I207
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-2121
Mailing Address - Country:US
Mailing Address - Phone:253-306-6065
Mailing Address - Fax:
Practice Address - Street 1:105 W 8TH AVE STE 350
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2312
Practice Address - Country:US
Practice Address - Phone:509-474-2232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA607542231835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist