Provider Demographics
NPI:1477800381
Name:IHN, JISEON (MSW)
Entity Type:Individual
Prefix:MS
First Name:JISEON
Middle Name:
Last Name:IHN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19500 HIDDEN SPRINGS RD APT 29
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-2341
Mailing Address - Country:US
Mailing Address - Phone:503-635-5527
Mailing Address - Fax:
Practice Address - Street 1:19500 HIDDEN SPRINGS RD APT 29
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-2341
Practice Address - Country:US
Practice Address - Phone:503-635-5527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker