Individual
MR. ANDREW JIHO PARK I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
921 14TH AVE, LONGVIEW, WA 98632-2316
(360) 423-0203
Mailing address
921 14TH AVE, LONGVIEW, WA 98632-2316
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/17/2014
Last updated
08/17/2015
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