Provider Demographics
NPI:1568504108
Name:YOON, DUKE B (OD)
Entity Type:Individual
Prefix:
First Name:DUKE
Middle Name:B
Last Name:YOON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5202 100TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-3892
Mailing Address - Country:US
Mailing Address - Phone:253-582-0760
Mailing Address - Fax:253-588-8988
Practice Address - Street 1:5202 100TH ST SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3892
Practice Address - Country:US
Practice Address - Phone:253-582-0760
Practice Address - Fax:253-588-8988
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00001580152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist