Provider Demographics
NPI:1447587720
Name:SONG, UN HA (DC)
Entity Type:Individual
Prefix:
First Name:UN
Middle Name:HA
Last Name:SONG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 SE EVERETT MALL WAY
Mailing Address - Street 2:SUITE M7
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-3239
Mailing Address - Country:US
Mailing Address - Phone:425-348-8888
Mailing Address - Fax:425-348-8887
Practice Address - Street 1:221 SE EVERETT MALL WAY
Practice Address - Street 2:SUITE M7
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3239
Practice Address - Country:US
Practice Address - Phone:425-348-8888
Practice Address - Fax:425-348-8887
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-07
Last Update Date:2009-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60118922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor