Provider Demographics
NPI:1679977151
Name:RYU, JIHOON (DC)
Entity Type:Individual
Prefix:
First Name:JIHOON
Middle Name:
Last Name:RYU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:JAY
Other - Middle Name:
Other - Last Name:RYU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:8704 RAINIER AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-4927
Mailing Address - Country:US
Mailing Address - Phone:206-722-0299
Mailing Address - Fax:206-722-0436
Practice Address - Street 1:8704 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-4927
Practice Address - Country:US
Practice Address - Phone:206-722-0299
Practice Address - Fax:206-722-0436
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60493067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor