Provider Demographics
NPI:1982740650
Name:SEOUL CHINESE HERBS, INC.
Entity Type:Organization
Organization Name:SEOUL CHINESE HERBS, INC.
Other - Org Name:SEOUL ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-584-8649
Mailing Address - Street 1:8718 S TACOMA WAY
Mailing Address - Street 2:#A-2
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499
Mailing Address - Country:US
Mailing Address - Phone:253-584-8649
Mailing Address - Fax:253-584-0701
Practice Address - Street 1:8718 S TACOMA WAY
Practice Address - Street 2:SUITE #A-2
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-4597
Practice Address - Country:US
Practice Address - Phone:253-584-8649
Practice Address - Fax:253-584-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000548171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty