Provider Demographics
NPI:1275607673
Name:OH, CHANGIK (DC)
Entity Type:Individual
Prefix:DR
First Name:CHANGIK
Middle Name:
Last Name:OH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 S DASH POINT RD STE B
Mailing Address - Street 2:SUITE B
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-3753
Mailing Address - Country:US
Mailing Address - Phone:253-946-4648
Mailing Address - Fax:253-946-4649
Practice Address - Street 1:1520 S DASH POINT RD STE B
Practice Address - Street 2:SUITE B
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-3753
Practice Address - Country:US
Practice Address - Phone:253-946-4648
Practice Address - Fax:253-946-4649
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002389111N00000X
CA19935111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2025948Medicaid
WA8868005Medicare PIN
WA2025948Medicaid