Provider Demographics
NPI:1528485695
Name:JO-SHI, IRIS (DO)
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:JO-SHI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:IRIS
Other - Middle Name:
Other - Last Name:JO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:3023 HAMAKER CT STE 600
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2241
Mailing Address - Country:US
Mailing Address - Phone:703-876-2788
Mailing Address - Fax:703-839-8764
Practice Address - Street 1:3023 HAMAKER CT STE 600
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2241
Practice Address - Country:US
Practice Address - Phone:703-876-2788
Practice Address - Fax:703-839-8764
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA01022062122080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program