Provider Demographics
NPI:1356134001
Name:DONGHWA PRIME WELLNESS INC
Entity type:Organization
Organization Name:DONGHWA PRIME WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANGHEON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-213-9793
Mailing Address - Street 1:23415 NE 11TH CT
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-6868
Mailing Address - Country:US
Mailing Address - Phone:415-310-4789
Mailing Address - Fax:
Practice Address - Street 1:14575 NE BEL RED RD STE 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3908
Practice Address - Country:US
Practice Address - Phone:425-641-8052
Practice Address - Fax:425-641-8053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty