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NPI Code Detail

MEDICARE: JASON JAEHOON CHUNG

MEDICARE: JASON JAEHOON CHUNG
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
1305R00000XPreferred Provider Organization3954WA

General Provider Information

NPI Number : 1770606089
Entity Type Code : Organization
Provider Name (Legal Business Name) : JASON JAEHOON CHUNG
Provider Business Mailing Address
First Line : 1201 39TH AVE SW
Second Line :
City : PUYALLUP
State : WA
Zip : 98373-3803
Country : US
Telephone Number : 253-435-0622
Fax Number :
Provider Business Practice Location Address
First Line : 1201 39TH AVE SW
Second Line :
City : PUYALLUP
State : WA
Zip : 98373-3803
Country : US
Telephone Number : 253-435-0622
Fax Number :
Authorized Official
Title or Position : OPTOMETRIST
Name : DR. JASON J CHUNG
Credential : O.D.
Telephone Number : 253-435-0622
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/24/2008

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Directions to “JASON JAEHOON CHUNG ” Practice Location

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