Individual
SANGKUN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2120 EXCHANGE ST, STE 200, ASTORIA, OR 97103-3364
(503) 325-5360
(503) 325-9373
Mailing address
2120 EXCHANGE ST, STE 200, ASTORIA, OR 97103-3364
(503) 325-5360
(503) 325-9373
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD18585
OR
2471B0102X
Bone Densitometry Radiologic Technologist
—
—
2471C3402X
Radiography Radiologic Technologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061320
—
OR
05
—
1091644
—
WA
Enumeration date
11/07/2006
Last updated
02/25/2009
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