Individual
KEN JONGHO PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2400 LANCASTER DR NE, SALEM, OR 97305-1221
(503) 361-5400
Mailing address
2400 LANCASTER DR NE, SALEM, OR 97305-1221
(503) 361-5400
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD150901
OR
207RN0300X
Nephrology Physician
MD60140050
WA
Other
Enumeration date
07/30/2008
Last updated
02/04/2022
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