Provider Demographics
NPI:1295165108
Name:JUNG, CHANIL (DC)
Entity type:Individual
Prefix:
First Name:CHANIL
Middle Name:
Last Name:JUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6840 FORT DENT WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2595
Mailing Address - Country:US
Mailing Address - Phone:206-466-1880
Mailing Address - Fax:206-466-1880
Practice Address - Street 1:6840 FORT DENT WAY STE 120
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2595
Practice Address - Country:US
Practice Address - Phone:206-466-1880
Practice Address - Fax:206-466-1880
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2017-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60415454111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor