Provider Demographics
NPI:1144738428
Name:AHN, DOORI (LAC)
Entity Type:Individual
Prefix:
First Name:DOORI
Middle Name:
Last Name:AHN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7360 MCWHORTER PL STE 100
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-5633
Mailing Address - Country:US
Mailing Address - Phone:703-375-9057
Mailing Address - Fax:
Practice Address - Street 1:7360 MCWHORTER PL STE 100
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-5633
Practice Address - Country:US
Practice Address - Phone:703-375-9057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-19
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000868171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist