Active NPI
John Kyu Song
- Acupuncturist
- Spokane, WA
National Provider Identifier
1134559164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC00000284
- Practice address
- 9825 N Indian Trail Rd
Spokane, WA 99208-9359 - Phone
- (509) 768-0366
- NPI assigned
- Nov 12, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | AC00000284 | WA | Primary |
Addresses
Primary practice location
9825 N Indian Trail Rd
Spokane, WA 99208-9359
Mailing address
430 W 2ND Ave
Suite 101
Spokane, WA 99201-6003
Phone (509) 768-0366
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 |
|---|---|---|---|
| AC00000284 | WA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384214400000",
"number": "1134559164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 W 2ND AVE",
"address_2": "SUITE 101",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992016003",
"telephone_number": "509-768-0366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9825 N INDIAN TRAIL RD",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992089359",
"telephone_number": "509-768-0366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "JOHN",
"middle_name": "KYU",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-12",
"last_updated": "2013-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "WA",
"license": "AC00000284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.