Provider Demographics
NPI:1033282777
Name:YOON, JUSTIN K (MD)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:K
Last Name:YOON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17382 SE 54TH PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-5919
Mailing Address - Country:US
Mailing Address - Phone:253-761-4200
Mailing Address - Fax:253-383-3553
Practice Address - Street 1:17382 SE 54TH PL
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-5919
Practice Address - Country:US
Practice Address - Phone:206-310-7710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000370002085B0100X
WAMD000370002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8881872OtherPTAN-MIO1
WAAB36535OtherMEDICARE PIN TRA KING COUNTY
WAAB37885OtherMEDICARE PIN ADVANCED OPEN IMAGING
WA0249559OtherLABOR AND INDUSTRIES-MEDICAL IMAGING ON 1ST
WA7252YOOtherREGENCE BLUE SHIELD UNION AVENUE OPEN
WA8951825OtherLABOR AND INDUSTRIES CRIME VICTIMS-MEDICAL IMAGING ON 1ST
WA158188OtherLABOR AND INDUSTRIES/WC TRA
WA1940YOOtherREGENCE BLUE SHIELD ADVANCED OPEN IMAGING
WA8296378Medicaid
WA170311OtherLABOR AND INDUSTRIES/WC ADVANCED OPEN IMAGING
WA300128232OtherRR MEDICARE TRA
WA158190OtherLABOR AND INDUSTRIES/WC UNION AVENUE OPEN
WA3231YOOtherREGENCE BLUE SHIELD TRA
WA300128232OtherRR MEDICARE TRA
WA7252YOOtherREGENCE BLUE SHIELD UNION AVENUE OPEN
WA8296378Medicaid