Provider Demographics
NPI:1730576794
Name:JUNG, KIHYUK ROY (DC)
Entity type:Individual
Prefix:DR
First Name:KIHYUK
Middle Name:ROY
Last Name:JUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12311 32ND AVE NE APT 409
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-5599
Mailing Address - Country:US
Mailing Address - Phone:206-293-5508
Mailing Address - Fax:
Practice Address - Street 1:13751 LAKE CITY WAY NE STE 310
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-8631
Practice Address - Country:US
Practice Address - Phone:425-954-6524
Practice Address - Fax:206-962-4999
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-16
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60539446111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician