Provider Demographics
NPI:1235730490
Name:YOON, JEEAH KIM (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEEAH
Middle Name:KIM
Last Name:YOON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 E GLEBE RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22305-3045
Mailing Address - Country:US
Mailing Address - Phone:703-299-0471
Mailing Address - Fax:703-548-1082
Practice Address - Street 1:621 E GLEBE RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22305-3045
Practice Address - Country:US
Practice Address - Phone:703-299-0471
Practice Address - Fax:703-548-1082
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212376183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist