Provider Demographics
NPI:1316736366
Name:JEOUNG, JINHEE (APRN-NP)
Entity type:Individual
Prefix:
First Name:JINHEE
Middle Name:
Last Name:JEOUNG
Suffix:
Gender:F
Credentials:APRN-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5902 PORT STEWART CT SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-9034
Mailing Address - Country:US
Mailing Address - Phone:503-428-0042
Mailing Address - Fax:
Practice Address - Street 1:5902 PORT STEWART CT SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-9034
Practice Address - Country:US
Practice Address - Phone:503-428-0042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10044204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty