Provider Demographics
NPI:1184660029
Name:YOU, JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:
Last Name:YOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8904 W TUCANNON AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7178
Mailing Address - Country:US
Mailing Address - Phone:509-627-2848
Mailing Address - Fax:509-627-2849
Practice Address - Street 1:8904 W TUCANNON AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7178
Practice Address - Country:US
Practice Address - Phone:509-627-2848
Practice Address - Fax:509-627-2849
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000413232081P2900X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1116482Medicaid
WA1116482Medicaid
WAGAB32649Medicare PIN
WAXY7840247OtherSUBOXONE DEA
WAGAB32649Medicare PIN