Individual provider Active NPI

Jehoung Yoo

  • Licensed Practical Nurse
  • Lakewood, WA
National Provider Identifier
1063971794
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP60934892 Issued in WA
Practice address
9720 S Tacoma Way
Lakewood, WA 98499-4456
Phone
(253) 503-3666
NPI assigned
Mar 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP60934892 WA Primary

Addresses

Primary practice location

9720 S Tacoma Way
Lakewood, WA 98499-4456

Mailing address

15 Oregon Ave Ste 308
Lakewood, WA 98409-7462
Phone (253) 503-3666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP60934892WAMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1063971794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 OREGON AVE STE 308",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984097462",
            "telephone_number": "253-503-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9720 S TACOMA WAY",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984994456",
            "telephone_number": "253-503-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO",
        "first_name": "JEHOUNG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP60934892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.