Provider Demographics
NPI:1366767170
Name:KIM, HYUNJUN (DC)
Entity type:Individual
Prefix:
First Name:HYUNJUN
Middle Name:
Last Name:KIM
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 1:3333 184TH ST SW
Mailing Address - Street 2:SUITE # R
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4724
Mailing Address - Country:US
Mailing Address - Phone:425-775-1313
Mailing Address - Fax:425-775-1313
Practice Address - Street 1:3333 184TH ST. SW
Practice Address - Street 2:SUITE # R
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037
Practice Address - Country:US
Practice Address - Phone:425-775-1313
Practice Address - Fax:425-775-1313
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011606111N00000X
WACH 60203269111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor