Individual provider Active NPI

Sung Soo Han

  • Acupuncturist
  • Lynnwood, WA
National Provider Identifier
1336492990
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC60177718 Issued in WA
Practice address
4710 168TH St SW
Lynnwood, WA 98037
Phone
(425) 772-4926
Fax
(425) 582-7619
NPI assigned
Oct 19, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC60177718 WA Primary

Addresses

Primary practice location

4710 168TH St SW
Lynnwood, WA 98037

Mailing address

4710 168TH St SW
Lynnwood, WA 98037-6813
Phone (425) 772-4926

Other practice location 1

3333 184th St SW Ste W
Lynnwood, WA 98037-4742
Phone (425) 640-7585

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
AC60177718WAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Acupuncture & Natural Medicine Acupuncturist Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1336492990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 168TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980376813",
            "telephone_number": "425-772-4926",
            "fax_number": "425-526-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 168TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98037",
            "telephone_number": "425-772-4926",
            "fax_number": "425-582-7619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 184th St SW Ste W",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980374742",
            "country_code": "US",
            "telephone_number": "425-640-7585",
            "fax_number": "425-526-6272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAN",
        "first_name": "SUNG SOO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-19",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC60177718",
            "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 4, 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.