Provider Demographics
NPI:1336589068
Name:LEEYOON, MIYOUNG (RN)
Entity Type:Individual
Prefix:MRS
First Name:MIYOUNG
Middle Name:
Last Name:LEEYOON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16322 65TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-8722
Mailing Address - Country:US
Mailing Address - Phone:425-246-7962
Mailing Address - Fax:
Practice Address - Street 1:16322 65TH AVE SE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-8722
Practice Address - Country:US
Practice Address - Phone:425-246-7962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00131267163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse