Provider Demographics
NPI:1447527064
Name:KIM, BYUNGSUNG (DC)
Entity type:Individual
Prefix:DR
First Name:BYUNGSUNG
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:BYUNG
Other - Middle Name:SUNG
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:19514 64TH AVE W
Mailing Address - Street 2:SUITE B
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-5105
Mailing Address - Country:US
Mailing Address - Phone:425-775-7550
Mailing Address - Fax:425-775-7551
Practice Address - Street 1:19514 64TH AVE W
Practice Address - Street 2:SUITE B
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5105
Practice Address - Country:US
Practice Address - Phone:425-775-7550
Practice Address - Fax:425-775-7551
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60207958111N00000X
CA32068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor