NPIMap

Organization Active NPI

Northwest Spine Clinic

  • Chiropractor
  • Lynnwood, WA
National Provider Identifier
1306297221
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60539446 Issued in WA
Legal business name
NORTHWEST SPINE CLINIC
Practice address
4629 168TH St SW Ste B
Lynnwood, WA 98037-8640
Phone
(425) 741-0600
Fax
(425) 741-0601
NPI assigned
Jun 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Authorized official

Name
Dr. Roy Kihyuk Jung, DC
Title
President
Phone
(425) 741-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH60539446 WA Primary

Addresses

Primary practice location

4629 168TH St SW Ste B
Lynnwood, WA 98037-8640

Mailing address

4629 168TH St SW Ste B
Lynnwood, WA 98037-8640
Phone (425) 741-0600

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1306297221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4629 168TH ST SW STE B",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980378640",
            "telephone_number": "425-741-0600",
            "fax_number": "425-741-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4629 168TH ST SW STE B",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980378640",
            "telephone_number": "425-741-0600",
            "fax_number": "425-741-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST SPINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "KIHYUK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-741-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60539446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.