Provider Demographics
NPI:1417911363
Name:OH, JUDITH EUNJUNG (OD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:EUNJUNG
Last Name:OH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9505 STEELE ST S
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-6858
Mailing Address - Country:US
Mailing Address - Phone:253-597-6800
Mailing Address - Fax:253-597-6888
Practice Address - Street 1:2914 S ALDER ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-4819
Practice Address - Country:US
Practice Address - Phone:253-272-9245
Practice Address - Fax:253-272-9413
Is Sole Proprietor?:No
Enumeration Date:2006-04-15
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00004014152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3985872OtherCIGNA
WAQMP000003361514OtherMOLINA
WA1016897OtherCOVENTRY HEALTH CARE
WA2032522Medicaid
WA1016897OtherFIRST HEALTH
WAP00407154OtherRAILROAD MEDICARE
WA749912OtherAETNA
WA216087OtherLABOR & INDUSTRIES
AKOD409WAOtherALASKA MEDICAID
WAG8866071Medicare PIN
WA3985872OtherCIGNA
WAG8863806Medicare PIN