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General NPI Number Information
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NPI Number | 1639404890
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL ONE CHIROPRACTIC PS CORP.
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Dates
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Enumeration Date | 10/06/2009
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Last Update Date | 10/06/2009
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Provider Practice Location Address
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Address Line | 6951 MLK JR WAY S STE 101
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City | SEATTLE
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State | WA
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Zip | 98118-3545
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Country | US
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Telephone | 206-721-7200
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Fax | 206-339-7200
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Provider Business Mailing Address
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Address Line | 6951 MLK JR WAY S STE 101
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City | SEATTLE
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State | WA
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Zip | 98118-3545
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Country | US
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Telephone | 206-721-7200
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Fax | 206-339-7200
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | YOUNG WUK AN
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Credential | DC
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Telephone | 206-721-7200
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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 | CH00003391
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH60064547
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License Number State | WA
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