NPIMap

Individual provider Active NPI

Soochul Song

  • Student in an Organized Health Care Education/Training Program
  • Seattle, WA
National Provider Identifier
1831607175
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2329 4TH Ave
Seattle, WA 98121-1717
Phone
(206) 461-3649
NPI assigned
Jan 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Psychologist 103TA0400X
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2329 4TH Ave
Seattle, WA 98121-1717

Mailing address

6400 Southcenter Blvd
Tukwila, WA 98188-2547

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sound CurrentSince Oct 11, 2023 Accepting new patients
Community Psychiatric Clinic Inc CurrentSince Oct 5, 2021 Accepting new patients
Asian American Chemical Dependency Treatment Services Past Accepting new patients
Asian American Chemical Dependency Treatment Services Past Accepting new patients

Locations

2329 4th Ave
Seattle, WA 98121
Phone (206) 461-3649

6400 Southcenter Blvd
Tukwila, WA 98188
Phone (206) 444-3600

Organizations & group practices 4

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": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1831607175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SOUTHCENTER BLVD",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2329 4TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211717",
            "telephone_number": "206-461-3649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "SOOCHUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-22",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 30, 2021; 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.