| Doctor Name: | MS. EZY HANBYUL YOO |
| NPI Number: | 1558780528 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | AP60427030 |
| Business Practice Address: | 300 Oak St Suite B Kelso, WA - 986262304 |
| Business Phone Number: | 3603535511 |
| Business Fax Number: | |
| Mailing Address: | 300 Oak St, Suite B KELSO |
| State: | WA |
| Postal Code: | 986262304 |
| Phone Number: | 3603535511 |
| Fax Number: | |
| NPI Enumeration Date: | 04/07/2014 |
| NPI Last Update Date: | 04/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | AP60427030 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |