MEDICARE: CHANIL JUNG D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	60415454	WA

General Provider Information

NPI Number	:	1295165108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANIL JUNG D.C.

Provider Business Mailing Address
First Line	:	6840 FORT DENT WAY STE 120
Second Line	:
City	:	TUKWILA
State	:	WA
Zip	:	98188-2595
Country	:	US
Telephone Number	:	206-466-1880
Fax Number	:	206-466-1880

Provider Business Practice Location Address
First Line	:	6840 FORT DENT WAY STE 120
Second Line	:
City	:	TUKWILA
State	:	WA
Zip	:	98188-2595
Country	:	US
Telephone Number	:	206-466-1880
Fax Number	:	206-466-1880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2013
Last Update Date	:	10/29/2017

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Directions to “ CHANIL JUNG D.C.” Practice Location

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