Provider Demographics
NPI:1366940819
Name:HWANG, ZENOVIA HYEJIN (LAC, EAMP)
Entity type:Individual
Prefix:
First Name:ZENOVIA
Middle Name:HYEJIN
Last Name:HWANG
Suffix:
Gender:F
Credentials:LAC, EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16414 40TH PL W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-9023
Mailing Address - Country:US
Mailing Address - Phone:206-552-8749
Mailing Address - Fax:
Practice Address - Street 1:18528 FIRLANDS WAY N STE B
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3985
Practice Address - Country:US
Practice Address - Phone:425-615-6188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-30
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X, 225400000X
WAAC60819855171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No174H00000XOther Service ProvidersHealth Educator
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner