Provider Demographics
NPI:1124134887
Name:LEE-JONES, YEONJOO (DC)
Entity type:Individual
Prefix:DR
First Name:YEONJOO
Middle Name:
Last Name:LEE-JONES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1296 S SHASTA AVE
Mailing Address - Street 2:
Mailing Address - City:EAGLE POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97524-8521
Mailing Address - Country:US
Mailing Address - Phone:541-830-4325
Mailing Address - Fax:541-826-2620
Practice Address - Street 1:1296 S SHASTA AVE
Practice Address - Street 2:
Practice Address - City:EAGLE POINT
Practice Address - State:OR
Practice Address - Zip Code:97524-8521
Practice Address - Country:US
Practice Address - Phone:541-830-4325
Practice Address - Fax:541-826-2620
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1260111N00000X
OR5836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMU60986Medicare UPIN