Individual
DANIEL ILWOO PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
15433 COUNTRY CLUB DR, UNIT A206, MILL CREEK, WA 98012-1260
(425) 890-5857
Mailing address
PO BOX 13524, MILL CREEK, WA 98082-1524
(425) 890-5857
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60240620
WA
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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