NPIMap

Individual provider Active NPI

Joon Kyung Song, MD

  • Diagnostic Radiology Physician
  • Tacoma, WA
National Provider Identifier
1598746232
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD00034694 Issued in WA
Practice address
1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone
(253) 761-4200
Fax
(253) 761-4201
NPI assigned
Nov 9, 2005
Last updated
Aug 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X MD162209 OR
Neuroradiology Physician 2085N0700X MD00034694 WA
Diagnostic Radiology Physician 2085R0202X MD162209 OR
Diagnostic Radiology Physician 2085R0202X MD00034694 WA Primary

Addresses

Primary practice location

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900

Mailing address

PO Box 1535
Tacoma, WA 98401-1535
Phone (253) 761-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080613000110 WA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 9537065149 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of California, San Francisco School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Avenue Open MRI LLCGroup PAC ID 5597652917, 44 clinicians
Tra-Minw P SGroup PAC ID 2163316167, 152 clinicians

Practice addresses (Care Compare)

222 15TH Ave SE
Puyallup, WA 98372-3754
Phone (253) 841-4353

2502 S Union Ave
Tacoma, WA 98405-1328
Phone (253) 841-4353

3402 S 18TH St
Tacoma, WA 98405-1903
Phone (253) 841-4353

4700 Point Fosdick Dr
Suite 111
Gig Harbor, WA 98335-1706
Phone (253) 841-4353

4700 Point Fosdick Dr NW
Suite 110
Gig Harbor, WA 98335-1706
Phone (253) 841-4353

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Mar 1, 2017 Accepting new patients
Tra-Minw P S CurrentSince Jul 1, 2008 Accepting new patients
Tra Medical Imaging Centers LLC CurrentSince Dec 1, 2025 Accepting new patients
Union Avenue Open MRI LLC CurrentSince Jul 1, 2008 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Mar 1, 2017 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance Past Accepting new patients
UCLA Radiology Medical Group Neuroradiology Past Accepting new patients
Utmb Faculty Group Practice Diagnostic Radiology Past Accepting new patients

Locations

122 3rd St NE
Auburn, WA 98002
Phone (253) 833-7750

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

21110 Sr 410 E
Ste 110
Bonney Lake, WA 98391

2512 Wheaton Way
Bremerton, WA 98310
Phone (360) 782-3650

2512 Wheaton Way
#O
Bremerton, WA 98310
Phone (360) 782-3700

5900 State Highway 303 NE
Bremerton, WA 98311
Phone (253) 459-6633

1455 Battersby Ave
Enumclaw, WA 98022
Phone (253) 552-5615

3021 Griffin Ave
Enumclaw, WA 98022
Phone (253) 833-6241

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

4700 Point Fosdick Dr
Ste 110
Gig Harbor, WA 98335
Phone (253) 759-2622

9725 SE 36th St
Ste 114
Mercer Island, WA 98040

500 Lilly Rd NE
Ste 160
Olympia, WA 98506
Phone (360) 413-8307

11212 Sunrise Blvd E
Ste 200
Puyallup, WA 98374

222 15th Ave SE
Puyallup, WA 98372

3400 California Ave SW
Seattle, WA 98116
Phone (206) 320-3399

1304 Fawcett Ave
Ste 100
Tacoma, WA 98402
Phone (253) 680-3372

1624 S I St
Ste 405
Tacoma, WA 98405
Phone (253) 274-4545

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

1724 West Union Ave
Ste 100
Tacoma, WA 98405
Phone (253) 830-5200

2209 E 32nd St
Tacoma, WA 98404
Phone (206) 593-0244

2502 S Union Ave
Tacoma, WA 98405
Phone (253) 759-5900

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

3402 S 18th St
Tacoma, WA 98405
Phone (253) 383-1099

5919 100th St SW
Tacoma, WA 98499

9601 Steilacoom Blvd SW
Tacoma, WA 98498
Phone (253) 582-8900

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ei-trami

Organizations & group practices 9

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1598746232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1535",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984011535",
            "telephone_number": "253-761-4200",
            "fax_number": "253-383-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021900",
            "telephone_number": "253-761-4200",
            "fax_number": "253-761-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JOON",
        "middle_name": "KYUNG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "OR",
            "license": "MD162209",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "WA",
            "license": "MD00034694",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD162209",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00034694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.