Provider Demographics
NPI:1134293145
Name:CHUNG, JOSEPHINE EUN SUN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:EUN SUN
Last Name:CHUNG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JOSEPHINE
Other - Middle Name:EUN SUN
Other - Last Name:WON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 E 4TH PLAIN BLVD BLDG 18
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-3717
Mailing Address - Country:US
Mailing Address - Phone:971-334-9185
Mailing Address - Fax:360-737-1424
Practice Address - Street 1:1601 E 4TH PLAIN BLVD BLDG 18
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3717
Practice Address - Country:US
Practice Address - Phone:971-334-9185
Practice Address - Fax:360-737-1424
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA227741041C0700X
ORL68671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical