Individual
SEUNG YONG JI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 N LIBERTY ST STE 400, BOISE, ID 83704-8707
(208) 336-4368
Mailing address
2001 N 17TH ST, BOISE, ID 83702-0802
(215) 350-4624
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
1371968
ID
207Y00000X
Otolaryngology Physician
PG220922
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2020
Last updated
02/09/2026
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