Active NPI
Heesoon Jun, PH.D.
- Psychologist
- Olympia, WA
National Provider Identifier
1407073158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY00001144
- Practice address
- 3100 Sunset Beach Dr NW
Olympia, WA 98502-3556 - Phone
- (360) 866-4502
- NPI assigned
- Apr 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY00001144 | WA | Primary |
Addresses
Primary practice location
3100 Sunset Beach Dr NW
Olympia, WA 98502-3556
Mailing address
3100 Sunset Beach Dr NW
Olympia, WA 98502-3556
Phone (360) 866-4502
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 095918000 | Other | OR | REGENCE OF OREGON |
| 140707315801 | Other | OR | PROVIDENCE HEALTH PLAN |
| JU4714 | Other | WA | REGENCE |
| 140707315801 | Other | KY | MHN SERVICES |
| 210697100000 | Other | WA | PREMERA |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY00001144 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322006400000",
"number": "1407073158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 SUNSET BEACH DR NW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985023556",
"telephone_number": "360-866-4502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 SUNSET BEACH DR NW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985023556",
"telephone_number": "360-866-4502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUN",
"first_name": "HEESOON",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2011-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY00001144",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE OF OREGON",
"identifier": "095918000",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDENCE HEALTH PLAN",
"identifier": "140707315801",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "JU4714",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN SERVICES",
"identifier": "140707315801",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREMERA",
"identifier": "210697100000",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.