Provider Demographics
NPI:1568712875
Name:RICHARD KE'AUMOANA CHUNG, MS ND NATUROPATHIC FAMILY PHYSICIAN, LTD
Entity Type:Organization
Organization Name:RICHARD KE'AUMOANA CHUNG, MS ND NATUROPATHIC FAMILY PHYSICIAN, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:206-724-1253
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:
Practice Address - Street 1:23700 EDMONDS WAY
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8978
Practice Address - Country:US
Practice Address - Phone:206-724-1253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHARD KE'AUMOANA CHUNG, MS ND NATUROPATHIC FAMILY PHYSICIAN, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site