Provider Demographics
NPI:1407286172
Name:YOO, HEEJONG (DC)
Entity Type:Individual
Prefix:DR
First Name:HEEJONG
Middle Name:
Last Name:YOO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18879 SW TUALATIN VALLEY HWY
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97003-2833
Mailing Address - Country:US
Mailing Address - Phone:503-430-1768
Mailing Address - Fax:
Practice Address - Street 1:18879 SW TUALATIN VALLEY HWY
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97003-2833
Practice Address - Country:US
Practice Address - Phone:503-430-1768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-18
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5518111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor