Active NPI
Sung Jin Cheon, L.AC
- Acupuncturist
- Portland, OR
National Provider Identifier
1104097757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC01102
- Practice address
- 1320 SE 122ND Ave
Portland, OR 97233-1203 - Phone
- (503) 255-2575
- NPI assigned
- Mar 21, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC01102 | OR | Primary |
Addresses
Primary practice location
1320 SE 122ND Ave
Portland, OR 97233-1203
Mailing address
9011 SW Beaverton Hillsdale Hwy #1-E
Beaverton, OR 97005
Phone (503) 292-2048
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
| License | State | Type | Specialty |
|---|---|---|---|
| AC01102 | OR | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kun Bo Dang Acupuncture | Acupuncturist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Acupuncturist
- Portland, OR
- NPI 1366817736
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206057600000",
"number": "1104097757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9011 SW BEAVERTON HILLSDALE HWY #1-E",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "97005",
"telephone_number": "503-292-2048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 SE 122ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972331203",
"telephone_number": "503-255-2575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEON",
"first_name": "SUNG",
"middle_name": "JIN",
"name_prefix": "Mr.",
"credential": "L.AC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-21",
"last_updated": "2008-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OR",
"license": "AC01102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.