Provider Demographics
NPI:1609348713
Name:JOUN, SUNGJI (DPT)
Entity Type:Individual
Prefix:
First Name:SUNGJI
Middle Name:
Last Name:JOUN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 E 72ND ST STE A100
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98404-5906
Mailing Address - Country:US
Mailing Address - Phone:253-474-7474
Mailing Address - Fax:253-474-7479
Practice Address - Street 1:112 SKI BOWL RD
Practice Address - Street 2:
Practice Address - City:NORTH CREEK
Practice Address - State:NY
Practice Address - Zip Code:12853-2607
Practice Address - Country:US
Practice Address - Phone:518-251-2447
Practice Address - Fax:518-251-2980
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60961716225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY39993OtherLICENSE