Provider Demographics
NPI:1598255903
Name:SPORTS AND SPINE
Entity Type:Organization
Organization Name:SPORTS AND SPINE
Other - Org Name:SPORTS AND SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:HYUN
Authorized Official - Middle Name:
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-774-1538
Mailing Address - Street 1:PO BOX 827
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98009-0827
Mailing Address - Country:US
Mailing Address - Phone:425-774-1538
Mailing Address - Fax:
Practice Address - Street 1:3900 FACTORIA BLVD SE STE A
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1234
Practice Address - Country:US
Practice Address - Phone:425-774-1538
Practice Address - Fax:425-744-1527
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WASHINGTON CENTER FOR PAIN MANAGEMENT, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center