Healthcare Provider Details

I. General information

NPI: 1508731043
Provider Name (Legal Business Name): GWANGJE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31830 PACIFIC HWY S. SUITE B
FEDERAL WAY WA
98003-5449
US

IV. Provider business mailing address

31830 PACIFIC HWY S. SUITE B
FEDERAL WAY WA
98003-5449
US

V. Phone/Fax

Practice location:
  • Phone: 253-431-8316
  • Fax: 253-345-4303
Mailing address:
  • Phone: 253-431-8316
  • Fax: 253-345-4303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SEUNG TAEK OH
Title or Position: OWNER
Credential: L.AC/EAMP
Phone: 253-431-8316