Provider Demographics
NPI:1720329998
Name:JEONG, JUN (DC)
Entity type:Individual
Prefix:DR
First Name:JUN
Middle Name:
Last Name:JEONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27203 216TH AVE SE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-3273
Mailing Address - Country:US
Mailing Address - Phone:425-432-4621
Mailing Address - Fax:425-432-6495
Practice Address - Street 1:3715 FACTORIA BLVD SE STE B
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-6147
Practice Address - Country:US
Practice Address - Phone:425-373-5433
Practice Address - Fax:425-432-6495
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60311674111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor