Individual provider Active NPI

Youngwuk An, DC

  • Rehabilitation Chiropractor
  • Seattle, WA
National Provider Identifier
1518043181
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
CH 60064547 Issued in WA
Practice address
6951 Martin Luther King Jr Way S
#101
Seattle, WA 98118-3597
Phone
(206) 721-7200
Fax
(206) 339-7200
NPI assigned
Oct 27, 2006
Last updated
Feb 17, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X CH 60064547 WA Primary

Addresses

Primary practice location

6951 Martin Luther King Jr Way S
#101
Seattle, WA 98118-3597

Mailing address

6951 Martin Luther King Jr Way S
#101
Seattle, WA 98118-3597
Phone (206) 721-7200

Other identifiers 1

IdentifierTypeStateIssuer
4707680MedicaidMI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 60064547WAMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
New Health Chiropractic Care PC PastSince Sep 1, 2008 Accepting new patients
King Plaza Chiropractic Past Accepting new patients
International One Chiropractic PS Corp. PastSince Oct 13, 2009 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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1518043181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6951 MARTIN LUTHER KING JR WAY S",
            "address_2": "#101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981183597",
            "telephone_number": "206-721-7200",
            "fax_number": "206-339-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6951 MARTIN LUTHER KING JR WAY S",
            "address_2": "#101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981183597",
            "telephone_number": "206-721-7200",
            "fax_number": "206-339-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AN",
        "first_name": "YOUNGWUK",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WA",
            "license": "CH 60064547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4707680",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; 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.