NPIMap

Individual provider Active NPI

Moongi Han, MAOM

  • Acupuncturist
  • Lakewood, WA
National Provider Identifier
1205155785
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC60493370 Issued in WA
Practice address
3816 Steilacoom Blvd SW
Lakewood, WA 98499-4552
Phone
(847) 712-8125
NPI assigned
May 24, 2010
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC60493370 WA Primary
Acupuncturist 171100000X 198000925 IL

Addresses

Primary practice location

3816 Steilacoom Blvd SW
Lakewood, WA 98499-4552

Mailing address

7620 40TH St W Apt 1
University Place, WA 98466-3801
Phone (847) 712-8125

Other practice location 1

805 Plainfield Rd Ste 112
Darien, IL 60561-4289
Phone (630) 789-8080

Other identifiers 1

IdentifierTypeStateIssuer
198000925OtherILSTATE LICENSE

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
198000925ILMDAcupuncturist
AC60493370WAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Chirorpactic PLLC Past Accepting new patients
L.V. Chiropractic, Inc. Past Accepting new patients
Family Care Chiropractic and Acupuncture, PC Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1205155785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 40TH ST W APT 1",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984663801",
            "telephone_number": "847-712-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3816 STEILACOOM BLVD SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984994552",
            "telephone_number": "847-712-8125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "805 Plainfield Rd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Darien",
            "state": "IL",
            "postal_code": "605614289",
            "country_code": "US",
            "telephone_number": "630-789-8080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAN",
        "first_name": "MOONGI",
        "name_prefix": "Dr.",
        "credential": "MAOM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-24",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC60493370",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198000925",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "198000925",
            "state": "IL"
        }
    ],
    "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 Jun 11, 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.