Provider Demographics
NPI:1861515629
Name:KWON, YOON KYUNG (LAC)
Entity type:Individual
Prefix:
First Name:YOON
Middle Name:KYUNG
Last Name:KWON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22727 HIGHWAY 99
Mailing Address - Street 2:SUITE 110
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8381
Mailing Address - Country:US
Mailing Address - Phone:206-393-8252
Mailing Address - Fax:
Practice Address - Street 1:22727 HIGHWAY 99
Practice Address - Street 2:SUITE 110
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8381
Practice Address - Country:US
Practice Address - Phone:206-393-8252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC2796171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist