Organization Active NPI

Fdseattle Clinic Inc

  • Sports Physician Chiropractor
  • Seattle, WA
National Provider Identifier
1851824197
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
CH60415454 Issued in WA
Legal business name
FDSEATTLE CLINIC INC
Practice address
918 S Horton St
Ste 930
Seattle, WA 98134-1952
Phone
(425) 533-2325
NPI assigned
Apr 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Authorized official

Name
Dr. Chanil Jung, D.C.
Title
Chiropractor
Phone
(425) 533-2325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X CH60415454 WA Primary

Addresses

Primary practice location

918 S Horton St
Ste 930
Seattle, WA 98134-1952

Mailing address

918 S Horton St
Ste 930
Seattle, WA 98134-1952
Phone (425) 533-2325

National Provider Directory

National Provider Directory

Locations

918 S Horton St
Ste 930
Seattle, WA 98134
Phone (425) 533-2325

6840 Fort Dent Way
Ste 120
Tukwila, WA 98188
Phone (206) 466-1880

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1851824197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 S HORTON ST",
            "address_2": "STE 930",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981341952",
            "telephone_number": "425-533-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 S HORTON ST",
            "address_2": "STE 930",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981341952",
            "telephone_number": "425-533-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FDSEATTLE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-04",
        "last_updated": "2017-04-04",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "CHANIL",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "425-533-2325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "WA",
            "license": "CH60415454",
            "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 Apr 4, 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.