Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH61032328 | WA |
NPI | 1003448200 |
---|---|
Provider Name | Khai Van Huynh |
First Address | Shoreline, WA 98155-3806 |
Second Address | Shoreline, WA 98155-3806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2020 |
Last Update Date | 06/02/2020 |