Provider Demographics
NPI:1851860365
Name:RA, YOON JUNG (ACAG-NP/APRN)
Entity Type:Individual
Prefix:MS
First Name:YOON
Middle Name:JUNG
Last Name:RA
Suffix:
Gender:F
Credentials:ACAG-NP/APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34509 9TH AVE S
Mailing Address - Street 2:STE 203B
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6700
Mailing Address - Country:US
Mailing Address - Phone:253-944-2080
Mailing Address - Fax:253-944-2099
Practice Address - Street 1:2610 ALLEN ST APT 5410
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2447
Practice Address - Country:US
Practice Address - Phone:310-903-3754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139713363LA2100X, 363LG0600X
WAAP61005991363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology