Individual
MRS. JISUN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
816 NE 190TH ST, SHORELINE, WA 98155-2249
(206) 364-3777
Mailing address
PO BOX 55399, SHORELINE, WA 98155-0399
(206) 364-3777
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60299415
WA
Other
Enumeration date
10/15/2012
Last updated
10/16/2012
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