Healthcare Provider Details

I. General information

NPI: 1447587720
Provider Name (Legal Business Name): UN HA SONG D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2009
Last Update Date: 11/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 SE EVERETT MALL WAY SUITE M7
EVERETT WA
98208-3239
US

IV. Provider business mailing address

221 SE EVERETT MALL WAY SUITE M7
EVERETT WA
98208-3239
US

V. Phone/Fax

Practice location:
  • Phone: 425-348-8888
  • Fax: 425-348-8887
Mailing address:
  • Phone: 425-348-8888
  • Fax: 425-348-8887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH60118922
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: