Provider Demographics
NPI:1144561895
Name:YUN, JERE
Entity Type:Individual
Prefix:MRS
First Name:JERE
Middle Name:
Last Name:YUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 FOURTH ST
Mailing Address - Street 2:RM. 150
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-3312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:860 FOURTH ST
Practice Address - Street 2:RM. 150
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3312
Practice Address - Country:US
Practice Address - Phone:808-453-6960
Practice Address - Fax:808-453-6964
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI233235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist