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Individual
SONG Y. PARK
Active
Individual
SONG Y. PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1185938
TX
363L00000X
Nurse Practitioner
AP61211573
WA
363LF0000X
Family Nurse Practitioner
RN219551
GA
Other
Enumeration date
02/02/2015
Last updated
01/23/2025
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