Healthcare Provider Details

I. General information

NPI: 1467387415
Provider Name (Legal Business Name): GRACEFIELD WHOLE-PERSON HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8230 BOONE BLVD STE 170
RESTON VA
20192-0001
US

IV. Provider business mailing address

1656 PARKCREST CIR APT 101
RESTON VA
20190-4944
US

V. Phone/Fax

Practice location:
  • Phone: 410-627-6333
  • Fax:
Mailing address:
  • Phone: 410-627-6333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: EUN-KYUNG ANNA KIM
Title or Position: ACUPUNCTURIST
Credential: LAC
Phone: 410-627-6333