Provider Demographics
NPI:1528247111
Name:JANG, YUN-HEE (OD)
Entity type:Individual
Prefix:
First Name:YUN-HEE
Middle Name:
Last Name:JANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4680 NW MORETTI TER
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-9401
Mailing Address - Country:US
Mailing Address - Phone:503-681-2804
Mailing Address - Fax:
Practice Address - Street 1:1255 NE 48TH AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5008
Practice Address - Country:US
Practice Address - Phone:503-681-2804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2996T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist