Healthcare Provider Details

I. General information

NPI: 1982496683
Provider Name (Legal Business Name): JEE YOUNG KO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9030 35TH AVENUE SW SUITE 100
SEATTLE WA
98126
US

IV. Provider business mailing address

3655 TORRANCE BLVD 3RD FLOOR #6012
TORRANCE CA
90503
US

V. Phone/Fax

Practice location:
  • Phone: 425-830-0039
  • Fax: 817-405-7786
Mailing address:
  • Phone: 310-612-3337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95034757
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: