Provider Demographics
NPI:1376948406
Name:CHOI, WAN-KYU (DC, LAC, EAMP)
Entity Type:Individual
Prefix:DR
First Name:WAN-KYU
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:DC, LAC, EAMP
Other - Prefix:DR
Other - First Name:JONATHAN
Other - Middle Name:
Other - Last Name:CHOI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC, LAC, EAMP
Mailing Address - Street 1:8704 RAINIER AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-4927
Mailing Address - Country:US
Mailing Address - Phone:206-306-4941
Mailing Address - Fax:
Practice Address - Street 1:8704 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-4927
Practice Address - Country:US
Practice Address - Phone:206-722-0299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60501342111N00000X
WAAC60524863171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist