Individual provider Active NPI

Jungwon Yoon, BA, SUDP, AAC

  • Addiction (Substance Use Disorder) Counselor
  • Seattle, WA
National Provider Identifier
1104007228
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP60435489 Issued in WA
Practice address
2313 3Rd Ave
Seattle, WA 98121-1711
Phone
(206) 256-9865
Fax
(206) 256-4065
NPI assigned
Nov 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CG60140976 WA
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60435489 WA Primary

Addresses

Primary practice location

2313 3Rd Ave
Seattle, WA 98121-1711

Mailing address

2313 3Rd Ave
Seattle, WA 98121-1711
Phone (206) 256-9865

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
CG60140976WAMDCounselor
CP60435489WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Community Services of Western Washington PastSince Aug 1, 2021 Accepting new patients
Catholic Community Services of Western Washington PastSince Oct 30, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1104007228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2313 3RD AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211711",
            "telephone_number": "206-256-9865",
            "fax_number": "206-256-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2313 3RD AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211711",
            "telephone_number": "206-256-9865",
            "fax_number": "206-256-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "JUNGWON",
        "credential": "BA, SUDP, AAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-16",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG60140976",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60435489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.