Individual
SOO JUNG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
24430 STONE SPRINGS BLVD SUITE 275, DULLES, VA 20166-2270
(703) 858-3220
Mailing address
224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110010844
VA
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30018274670001
—
VA
Enumeration date
03/07/2025
Last updated
08/29/2025
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