Individual
DEREK PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
623 W MAIN ST, MONROE, WA 98272-2101
(360) 805-9060
Mailing address
12115 19TH AVE SE APT H303, EVERETT, WA 98208-6277
(425) 207-6827
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
61691554
WA
Other
Enumeration date
07/18/2025
Last updated
07/18/2025
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