Individual provider Active NPI

Youngjoo Koh, D.C

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1053761999
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
60655471 Issued in WA
Practice address
15350 SE 37TH St Ste 100
Bellevue, WA 98006-1732
Phone
(563) 468-9623
NPI assigned
Jun 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 60655471 WA Primary

Addresses

Primary practice location

15350 SE 37TH St Ste 100
Bellevue, WA 98006-1732

Mailing address

4708 36TH Ave NE
Tacoma, WA 98422-4602
Phone (563) 468-9623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
60655471WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kore Chiropractic and Rehab Corporation Chiropractor Current Accepting new patients
Kore Plus Chiropractic Corp Chiropractor Current Accepting new patients

Locations

15350 SE 37th St
Ste 100
Bellevue, WA 98006
Phone (206) 408-4861

33507 9th Ave S
Ste H2
Federal Way, WA 98003
Phone (253) 344-1416

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
  • WA PPO C-SNP

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1053761999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4708 36TH AVE NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984224602",
            "telephone_number": "563-468-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15350 SE 37TH ST STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061732",
            "telephone_number": "563-468-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOH",
        "first_name": "YOUNGJOO",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "60655471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.