Healthcare Provider Details

I. General information

NPI: 1710318902
Provider Name (Legal Business Name): EUNYOUNG CHOI EAMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2013
Last Update Date: 12/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16510 CLEVELAND ST SUITE O
REDMOND WA
98052-4439
US

IV. Provider business mailing address

13000 ADMIRALTY WAY UNIT B 304
EVERETT WA
98204-6259
US

V. Phone/Fax

Practice location:
  • Phone: 425-869-7400
  • Fax:
Mailing address:
  • Phone: 425-830-7612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberNU60185180
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDI60344908
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC60330063
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: