Provider Demographics
NPI:1487477097
Name:KWUN, HAEWON
Entity type:Individual
Prefix:
First Name:HAEWON
Middle Name:
Last Name:KWUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20441 DONCASTER TER
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-4330
Mailing Address - Country:US
Mailing Address - Phone:857-288-8036
Mailing Address - Fax:
Practice Address - Street 1:8245 BOONE BLVD STE 630
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3894
Practice Address - Country:US
Practice Address - Phone:857-288-8036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-02
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU03108171100000X
VA0121001161171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturist