Basic Information
Provider Information
NPI: 1376894675
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHUNG
FirstName: KAREN
MiddleName: LEE
NamePrefix: MRS.
NameSuffix:  
Credential: MSN, FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 612 N 45TH ST UNIT B
Address2:  
City: SEATTLE
State: WA
PostalCode: 981036405
CountryCode: US
TelephoneNumber: 9098688847
FaxNumber:  
Practice Location
Address1: 4800 SAND POINT WAY NE
Address2:  
City: SEATTLE
State: WA
PostalCode: 981053901
CountryCode: US
TelephoneNumber: 2069872106
FaxNumber: 2069873946
Other Information
ProviderEnumerationDate: 09/26/2012
LastUpdateDate: 04/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X337907NYN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LF0000XAP60853387WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home