Healthcare Provider Details

I. General information

NPI: 1841790268
Provider Name (Legal Business Name): BRIAN P YOON ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 E BROADWAY AVE
REARDAN WA
99029-0629
US

IV. Provider business mailing address

10 NICHOLLS ST
DAVENPORT WA
99122-9729
US

V. Phone/Fax

Practice location:
  • Phone: 509-796-2737
  • Fax: 509-796-2738
Mailing address:
  • Phone: 509-725-7501
  • Fax: 509-725-7504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61302221
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: