Provider Demographics
NPI:1619231065
Name:CHON, BYONG IL (DC)
Entity Type:Individual
Prefix:
First Name:BYONG
Middle Name:IL
Last Name:CHON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4327 S 333RD ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98001-5146
Mailing Address - Country:US
Mailing Address - Phone:253-252-2636
Mailing Address - Fax:
Practice Address - Street 1:710A S 38TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98418-6718
Practice Address - Country:US
Practice Address - Phone:253-830-6898
Practice Address - Fax:253-830-6899
Is Sole Proprietor?:No
Enumeration Date:2012-06-30
Last Update Date:2012-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60288517111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor