Provider Demographics
NPI:1801423041
Name:JAYEON VISION
Entity type:Organization
Organization Name:JAYEON VISION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:425-444-1919
Mailing Address - Street 1:13204 96TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-5528
Mailing Address - Country:US
Mailing Address - Phone:425-444-1919
Mailing Address - Fax:
Practice Address - Street 1:13909 MERIDIAN E STE A3
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-9180
Practice Address - Country:US
Practice Address - Phone:253-841-1575
Practice Address - Fax:253-840-5543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-26
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty