Provider Demographics
NPI:1063618981
Name:KUN CHIROPRACTIC INC. P.S.
Entity type:Organization
Organization Name:KUN CHIROPRACTIC INC. P.S.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:S
Authorized Official - Last Name:KUN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-323-1666
Mailing Address - Street 1:1666 E OLIVE WAY
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-5627
Mailing Address - Country:US
Mailing Address - Phone:206-323-1666
Mailing Address - Fax:206-323-6639
Practice Address - Street 1:1666 E OLIVE WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-5627
Practice Address - Country:US
Practice Address - Phone:206-323-1666
Practice Address - Fax:206-323-6639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26215111N00000X
WACH00034832111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1487783098OtherINDIVIDUAL NPI- RUSSELL KUN D.C.
WA1487783098OtherINDIVIDUAL NPI- RUSSELL KUN D.C.