=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467387415
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GRACEFIELD WHOLE-PERSON HEALTHCARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2026
-----------------------------------------------------
Last Update Date | 06/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8230 BOONE BLVD STE 170
-----------------------------------------------------
City | RESTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20192-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-627-6333
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1656 PARKCREST CIR APT 101
-----------------------------------------------------
City | RESTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20190-4944
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-627-6333
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ACUPUNCTURIST
-----------------------------------------------------
Name | EUN-KYUNG ANNA KIM
-----------------------------------------------------
Credential | LAC
-----------------------------------------------------
Telephone | 410-627-6333
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------