MEDICARE: HAECHAN CHUNG DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH61420545	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CH.61420545	OTHER	WA	CHIROPRACTOR

General Provider Information

NPI Number	:	1922707736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAECHAN CHUNG DC

Provider Business Mailing Address
First Line	:	2122 164TH ST SW STE 203
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98087-7811
Country	:	US
Telephone Number	:	425-245-7122
Fax Number	:

Provider Business Practice Location Address
First Line	:	2122 164TH ST SW STE 203
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98087-7811
Country	:	US
Telephone Number	:	425-245-7122
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2023
Last Update Date	:	03/13/2026

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Directions to “ HAECHAN CHUNG DC” Practice Location

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