Provider Demographics
NPI:1922612738
Name:CHA, JIYOUNG (ARNP)
Entity Type:Individual
Prefix:
First Name:JIYOUNG
Middle Name:
Last Name:CHA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 RIMLAND DR STE 301
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8759
Mailing Address - Country:US
Mailing Address - Phone:253-922-4027
Mailing Address - Fax:
Practice Address - Street 1:7900 WILLOWS RD NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-6813
Practice Address - Country:US
Practice Address - Phone:425-885-0808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60390220163W00000X
WAAP61446771363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse