Provider Demographics
NPI:1821381419
Name:YU, JI YUN (OMD)
Entity type:Individual
Prefix:DR
First Name:JI YUN
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10803 MAIN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4746
Mailing Address - Country:US
Mailing Address - Phone:710-915-0118
Mailing Address - Fax:
Practice Address - Street 1:10803 MAIN ST STE 400
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4746
Practice Address - Country:US
Practice Address - Phone:703-915-0118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-16
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000526171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist