Basic Information
| Provider Information | |||||||||
| NPI: | 1851860365 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RA | ||||||||
| FirstName: | YOON | ||||||||
| MiddleName: | JUNG | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ACAG-NP/APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 34509 9TH AVE S | ||||||||
| Address2: | STE 203B | ||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980036700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539442080 | ||||||||
| FaxNumber: | 2539442099 | ||||||||
| Practice Location | |||||||||
| Address1: | 2610 ALLEN ST APT 5410 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752042447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3109033754 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2018 | ||||||||
| LastUpdateDate: | 05/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | AP139713 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363LA2100X | AP61005991 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363LG0600X | AP139713 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 363LG0600X | AP61005991 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.