Active NPI
Jin Koo
- Pharmacist
- Federal Way, WA
National Provider Identifier
1629545710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60877223
- Practice address
- 1014 S 320TH St
Ste G
Federal Way, WA 98003-5344 - Phone
- (253) 719-8554
- NPI assigned
- Oct 27, 2018
- Last updated
- Nov 19, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60877223 | WA | Primary |
Addresses
Primary practice location
1014 S 320TH St
Ste G
Federal Way, WA 98003-5344
Mailing address
1014 S 320TH St
Ste G
Federal Way, WA 98003-5344
Phone (253) 719-8554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH60877223 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hansol LLC. | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1014 S 320th St
Ste G
Federal Way, WA 98003
Phone (253) 719-8554
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605744000000",
"number": "1629545710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1014 S 320TH ST",
"address_2": "STE G",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980035344",
"telephone_number": "253-719-8554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1014 S 320TH ST",
"address_2": "STE G",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980035344",
"telephone_number": "253-719-8554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOO",
"first_name": "JIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-27",
"last_updated": "2020-11-19",
"certification_date": "2020-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60877223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Federal Way, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.