Individual
JIN YOUNG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
195 W 12TH AVE, EUGENE, OR 97401-3408
(541) 762-4325
(541) 762-0740
Mailing address
195 W 12TH AVE, EUGENE, OR 97401-3408
(541) 762-4325
(541) 762-0740
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201402848RN
OR
163W00000X
Registered Nurse
818327
CA
363LF0000X
Family Nurse Practitioner
Primary
201403802NP-PP
OR
363LF0000X
Family Nurse Practitioner
95000717
CA
Other
Enumeration date
05/22/2013
Last updated
03/20/2015
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