MEDICARE: YOO JUNG OH PHARM.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PH61070257	WA

General Provider Information

NPI Number	:	1063011039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOO JUNG OH PHARM.D

Provider Business Mailing Address
First Line	:	101 WELLSIAN WAY
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99352-4150
Country	:	US
Telephone Number	:	509-946-2833
Fax Number	:	509-943-3236

Provider Business Practice Location Address
First Line	:	2811 W 10TH AVE
Second Line	:
City	:	KENNEWICK
State	:	WA
Zip	:	99336-3104
Country	:	US
Telephone Number	:	509-735-8700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2020
Last Update Date	:	05/28/2026

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