PHC - Charm Zone Asian Medicine Clinic

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC60493370 Issued in WA

Legal business name

PHC - CHARM ZONE ASIAN MEDICINE CLINIC

Practice address

8730 S Tacoma Way
Suite 104
Lakewood, WA 98499-4521

Phone

(866) 778-9191

Fax

(253) 815-8772

NPI assigned

Jun 29, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Min Park, L.AC., O.M.D.

Title

Owner

Phone

(206) 960-3308

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1932550183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8730 S TACOMA WAY",
            "address_2": "SUITE 104",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984994521",
            "telephone_number": "866-778-9191",
            "fax_number": "253-815-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8730 S TACOMA WAY",
            "address_2": "SUITE 104",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984994521",
            "telephone_number": "866-778-9191",
            "fax_number": "253-815-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHC - CHARM ZONE ASIAN MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-29",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "MIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-960-3308",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "L.AC., O.M.D."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC60493370",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC00000376",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Petru
• Danielle K Pettaway
• Ashley Pettis, BS
• Thong Pham
• Van Tuy Phan, PA-C
• Sarah Phenisee, PHARMD
• Daryl Phill
• Kelly A Phillips, D.O.
• Faith Harmony Philmlee
• Linda Phimmavong, LMP

• Acupuncturist in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Acupuncturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.