Individual
DR. LISA WYSONG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3601 FREMONT AVE N, 316, SEATTLE, WA 98103
(206) 675-0366
(206) 675-0466
Mailing address
3601 FREMONT AVE N, #316, SEATTLE, WA 98103
(206) 675-0366
(206) 675-0466
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00006876
WA
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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