Individual
JASON PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1418 164TH ST SW STE 100, LYNNWOOD, WA 98087-8500
(425) 742-8828
Mailing address
1418 164TH ST SW STE 100, LYNNWOOD, WA 98087-8500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60868937
WA
Other
Enumeration date
08/10/2018
Last updated
08/10/2018
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