Provider Demographics
NPI:1740781731
Name:CHAE, KWANG HO (ND)
Entity Type:Individual
Prefix:DR
First Name:KWANG
Middle Name:HO
Last Name:CHAE
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6226 196TH ST SW STE 2D
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-5959
Mailing Address - Country:US
Mailing Address - Phone:206-333-2778
Mailing Address - Fax:206-278-1600
Practice Address - Street 1:6226 196TH ST SW STE 2D
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5959
Practice Address - Country:US
Practice Address - Phone:206-333-2778
Practice Address - Fax:206-278-1600
Is Sole Proprietor?:No
Enumeration Date:2018-02-24
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND972175F00000X
HIND298175F00000X
WANT60809269175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath