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Individual

MR. DENNIS CHAI SUN PARK I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA/MS, CADCIII, CDP

Contact information

Practice address
1230 7TH AVE, LONGVIEW, WA 98632-3166
(180) 025-7200
Mailing address
PO BOX 1562, WOODLAND, WA 98674-1500
(360) 575-4818

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00005610
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CP00005610
CHEMICAL DEPENDENCY WA
WA
Enumeration date
10/16/2006
Last updated
07/21/2022
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