Provider Demographics
NPI:1366632622
Name:CHOI, KYUNG BOK (LMP)
Entity Type:Individual
Prefix:MR
First Name:KYUNG
Middle Name:BOK
Last Name:CHOI
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9115 S TACOMA WAY
Mailing Address - Street 2:SUITE 109
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-4400
Mailing Address - Country:US
Mailing Address - Phone:253-582-5500
Mailing Address - Fax:253-582-6171
Practice Address - Street 1:9115 S TACOMA WAY
Practice Address - Street 2:SUITE 109
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-4400
Practice Address - Country:US
Practice Address - Phone:253-582-5500
Practice Address - Fax:253-582-6171
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017421225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist