Individual
MIN S PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
825 EASTLAKE AVE E, SEATTLE, WA 98109-4405
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
MD60211829
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0824PA
REGENCE
WA
05
—
1740389337
—
WA
05
—
202672602
—
TX
01
—
279756
LNI
WA
Enumeration date
09/21/2006
Last updated
02/12/2025
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