NPIMap

Individual provider Active NPI

Sungjun Jung, D.C.

  • Chiropractor
  • Lynnwood, WA
National Provider Identifier
1831452788
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60282827 Issued in WA
Practice address
4629 168TH St SW Ste B
Lynnwood, WA 98037-8640
Phone
(425) 741-0600
Fax
(425) 741-0601
NPI assigned
Jun 15, 2012
Last updated
Apr 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60282827 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

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
CH60282827WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Back to Wellness Chiropractor Past Accepting new patients

Organizations & group practices 2

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": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1831452788",
    "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": {
        "last_name": "JUNG",
        "first_name": "SUNGJUN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60282827",
            "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 Apr 11, 2017; 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.