Provider Demographics
NPI:1528196052
Name:CHRISTIAN FAMILY CARE INC
Entity Type:Organization
Organization Name:CHRISTIAN FAMILY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-874-5404
Mailing Address - Street 1:8511 SOUTH TACOMA WAY #200
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98499
Mailing Address - Country:US
Mailing Address - Phone:253-588-4015
Mailing Address - Fax:253-588-4035
Practice Address - Street 1:33507 9TH AVE S
Practice Address - Street 2:BUILDING A
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6397
Practice Address - Country:US
Practice Address - Phone:253-874-5404
Practice Address - Fax:253-874-8964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044106207Q00000X
WAMD00029607207R00000X, 261QP2300X
WAAP30006909363LA2200X
WAAP30006915363LF0000X
WAAP30006808363LF0000X
WAAP60126966363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1014389Medicaid
1386694982OtherJAI JUN BYEON
WA1609836717OtherYOUNG JU NAM, ARNP
WA2003030Medicaid
WA1114743Medicaid
WA1922101500OtherYOUNG H. LEE, MD
WA8453284Medicaid
WA94964303Medicaid
WA1033556Medicaid
WA1679610885OtherKI-DEUK WOHLFERT, ARNP
1699004234OtherDOSOON SOH, ARNP
1022327OtherPROVIDERONE
0155621OtherL&I, YOUNG H. LEE, MD
WA2007050Medicaid
1022327OtherPROVIDERONE
1699004234OtherDOSOON SOH, ARNP
WA1033556Medicaid