Provider Demographics
NPI:1104007228
Name:YOON, JUNGWON (BA, SUDP, AAC)
Entity Type:Individual
Prefix:
First Name:JUNGWON
Middle Name:
Last Name:YOON
Suffix:
Gender:F
Credentials:BA, SUDP, AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2313 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1711
Mailing Address - Country:US
Mailing Address - Phone:206-256-9865
Mailing Address - Fax:206-256-4065
Practice Address - Street 1:2313 3RD AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1711
Practice Address - Country:US
Practice Address - Phone:206-256-9865
Practice Address - Fax:206-256-4065
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60140976101Y00000X, 101YM0800X
WACP60435489101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)