Healthcare Provider Details

I. General information

NPI: 1114886223
Provider Name (Legal Business Name): EUN YU JUNG MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 01/16/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 SE PROFESSIONAL MALL BLVD STE 204
PULLMAN WA
99163-5423
US

IV. Provider business mailing address

103 NW LANCER LN
PULLMAN WA
99163-2848
US

V. Phone/Fax

Practice location:
  • Phone: 509-570-3302
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.70019052
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: