Individual provider Active NPI

Chongin Kwon

  • Acupuncturist
  • Bellevue, WA
National Provider Identifier
1336470210
Registry record updated Jan 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
60088111 Issued in WA
Practice address
1105 Bellevue Way NE Ste A3
Bellevue, WA 98004-4299
Phone
(425) 455-1055
Fax
(425) 455-1055
NPI assigned
Jan 16, 2010
Last updated
Jan 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 60088111 WA Primary

Addresses

Primary practice location

1105 Bellevue Way NE Ste A3
Bellevue, WA 98004-4299

Mailing address

1105 Bellevue Way NE Ste A3
Bellevue, WA 98004-4299
Phone (425) 455-1055

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
60088111WAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1263600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263600000000",
    "number": "1336470210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 BELLEVUE WAY NE STE A3",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044299",
            "telephone_number": "425-455-1055",
            "fax_number": "425-455-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 BELLEVUE WAY NE STE A3",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044299",
            "telephone_number": "425-455-1055",
            "fax_number": "425-455-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "CHONGIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-16",
        "last_updated": "2010-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "60088111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2010; 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.