Individual
EUN JUNG YI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2312 NE 129TH ST, VANCOUVER, WA 98686-3236
(360) 696-5022
(360) 666-0466
Mailing address
PO BOX 821350, VANCOUVER, WA 98682-0030
(360) 696-5022
(360) 666-0466
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD153969
OR
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD153969
OR
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD60306086
WA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MED T 8395
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0307166
WA DEPT OF L&I
WA
05
—
1376731208
—
WA
01
—
3959280
CIGNA
—
01
—
500049
CHPW
WA
05
—
500651332
—
OR
01
—
617287700
US DEPT OF L&I - ASC
—
01
—
P01146797
RR MEDICARE
—
Enumeration date
10/04/2007
Last updated
10/08/2014
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