Provider Demographics
NPI:1477962439
Name:GOOD CARE SPINE CLINIC
Entity Type:Organization
Organization Name:GOOD CARE SPINE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNGJUN
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-741-0600
Mailing Address - Street 1:4629 168TH ST SW # C2
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-8640
Mailing Address - Country:US
Mailing Address - Phone:425-741-0600
Mailing Address - Fax:425-741-0601
Practice Address - Street 1:4629 168TH ST SW # C2
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-8640
Practice Address - Country:US
Practice Address - Phone:425-741-0600
Practice Address - Fax:425-741-0601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60282827111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty