Heesoon Jun, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY00001144 Issued in WA

Practice address

3100 Sunset Beach Dr NW
Olympia, WA 98502-3556

Phone

(360) 866-4502

NPI assigned

Apr 20, 2007

Last updated

Nov 23, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Olympia, WA
• Providers in Olympia, WA by specialty
• Psychologist in Washington

• 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.

Verify at the official NPI Registry.