Active NPI
Jong Gab Baeg, MTOM
- Acupuncturist
- Lakewood, WA
National Provider Identifier
1184816613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC00000630
- Practice address
- 8904 S Tacoma Way
Suite 6
Lakewood, WA 98499-4461 - Phone
- (253) 983-1943
- Fax
- (253) 983-9796
- NPI assigned
- Aug 17, 2007
- 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 | AC00000630 | WA | Primary |
Addresses
Primary practice location
8904 S Tacoma Way
Suite 6
Lakewood, WA 98499-4461
Mailing address
8904 S Tacoma Way
Suite 6
Lakewood, WA 98499-4461
Phone (253) 983-1943
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 |
|---|---|---|---|
| AC00000630 | WA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187308800000",
"number": "1184816613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8904 S TACOMA WAY",
"address_2": "SUITE 6",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984994461",
"telephone_number": "253-983-1943",
"fax_number": "253-983-9796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8904 S TACOMA WAY",
"address_2": "SUITE 6",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984994461",
"telephone_number": "253-983-1943",
"fax_number": "253-983-9796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAEG",
"first_name": "JONG",
"middle_name": "GAB",
"name_prefix": "Mr.",
"credential": "MTOM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-17",
"last_updated": "2007-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "WA",
"license": "AC00000630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.