Provider Demographics
NPI:1982878641
Name:HAN, EUNJOO (LAC, PHD)
Entity Type:Individual
Prefix:DR
First Name:EUNJOO
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:LAC, PHD
Other - Prefix:DR
Other - First Name:EJ
Other - Middle Name:
Other - Last Name:HAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC,PHD
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-0217
Mailing Address - Country:US
Mailing Address - Phone:206-851-3204
Mailing Address - Fax:206-851-3204
Practice Address - Street 1:3221 EASTLAKE AVE E
Practice Address - Street 2:SUITE 110
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-7125
Practice Address - Country:US
Practice Address - Phone:206-851-3204
Practice Address - Fax:206-275-3835
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC 00002695171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist