Provider Demographics
NPI:1689055287
Name:HAHN, ALICE MIN JUNG
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:MIN JUNG
Last Name:HAHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 112TH AVE NE
Mailing Address - Street 2:APT 428
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6487
Mailing Address - Country:US
Mailing Address - Phone:425-999-5121
Mailing Address - Fax:
Practice Address - Street 1:13400 NE 20TH ST
Practice Address - Street 2:#47
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2099
Practice Address - Country:US
Practice Address - Phone:206-437-5412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst