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General NPI Number Information
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NPI Number | 1639377302
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Entity Type | Organization
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Legal Business Name | ONE FAMILY CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17410 HIGHWAY 99 STE 150
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City | LYNNWOOD
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State | WA
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Zip | 98037-3632
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Country | US
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Telephone | 425-741-9927
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Fax | 425-741-0465
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Provider Business Mailing Address
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Address Line | 17410 HIGHWAY 99 STE 150
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City | LYNNWOOD
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State | WA
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Zip | 98037-3632
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Country | US
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Telephone | 425-741-9927
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Fax | 425-741-0465
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Authorized Official
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Title or Position | PRESIDENT
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Name | SANG KYUNG CHO
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Credential | D.C.
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Telephone | 425-741-9927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00034763
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License Number State | WA
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