Individual
MYUNG H JUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2517 NE KRESKY AVE, CHEHALIS, WA 98532-2409
(360) 748-8632
(360) 748-3869
Mailing address
PO BOX 1506, CHEHALIS, WA 98532-0409
(360) 242-3008
(360) 807-7687
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
007851
NY
152W00000X
Optometrist
27OA00642700
NJ
152W00000X
Optometrist
3523AT
OR
152W00000X
Optometrist
AT3523
OR
152W00000X
Optometrist
Primary
OD60394858
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750636726
—
OR
05
—
2060397
—
WA
Enumeration date
07/17/2012
Last updated
12/07/2020
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