Provider Demographics
NPI:1346886850
Name:DO, JIHYUN (NP)
Entity Type:Individual
Prefix:
First Name:JIHYUN
Middle Name:
Last Name:DO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5877 KARA PL
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-3334
Mailing Address - Country:US
Mailing Address - Phone:503-887-6937
Mailing Address - Fax:
Practice Address - Street 1:5877 KARA PL
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-3334
Practice Address - Country:US
Practice Address - Phone:503-887-6937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001263326163W00000X
VA0024178483363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse