Provider Demographics
NPI:1669505236
Name:BAEK, SEUNG GI (LAC)
Entity Type:Individual
Prefix:MR
First Name:SEUNG
Middle Name:GI
Last Name:BAEK
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:33720 9TH AVE S
Mailing Address - Street 2:#B-4
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6735
Mailing Address - Country:US
Mailing Address - Phone:253-874-1467
Mailing Address - Fax:253-874-2019
Practice Address - Street 1:33720 9TH AVE S
Practice Address - Street 2:#B-4
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6735
Practice Address - Country:US
Practice Address - Phone:253-874-1467
Practice Address - Fax:253-874-2019
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002659171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist