Individual provider Active NPI

Myung-Yum Joy Jo, RN

  • Registered Nurse
  • Renton, WA
National Provider Identifier
1336771856
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
00102273 Issued in WA
Practice address
1412 SW 43Rd St Ste 140
Renton, WA 98057-4803
Phone
(425) 264-0750
NPI assigned
Feb 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 00102273 WA Primary

Addresses

Primary practice location

1412 SW 43Rd St Ste 140
Renton, WA 98057-4803

Mailing address

13944 174TH Ter SE
Renton, WA 98059-6526
Phone (206) 356-2118

Other practice location 1

13944 174th Ter SE
Renton, WA 98059-6526
Phone (206) 356-2118

Other practice location 2

23415 18th Ave S Apt 4
Des Moines, WA 98198-7506
Phone (206) 356-2118

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
00102273WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1336771856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13944 174TH TER SE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980596526",
            "telephone_number": "206-356-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 SW 43RD ST STE 140",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574803",
            "telephone_number": "425-264-0750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13944 174th Ter SE",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980596526",
            "country_code": "US",
            "telephone_number": "206-356-2118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23415 18th Ave S Apt 4",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "WA",
            "postal_code": "981987506",
            "country_code": "US",
            "telephone_number": "206-356-2118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JO",
        "first_name": "MYUNG-YUM",
        "middle_name": "JOY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "00102273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.