Provider Demographics
NPI:1457488629
Name:CHOI, LEIF JONG SIK (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:LEIF
Middle Name:JONG SIK
Last Name:CHOI
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6163 SW MURRAY BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-4421
Mailing Address - Country:US
Mailing Address - Phone:503-626-3700
Mailing Address - Fax:503-643-6667
Practice Address - Street 1:6163 SW MURRAY BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-4421
Practice Address - Country:US
Practice Address - Phone:503-626-3700
Practice Address - Fax:503-643-6667
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273163111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor