Individual
SARAH PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12826 SE 40TH LN STE 201, BELLEVUE, WA 98006-4276
(425) 641-5303
Mailing address
4557 11TH AVE NE APT C238, SEATTLE, WA 98105-0002
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE61295550
WA
126800000X
Dental Assistant
D1 60580186
WA
Other
Enumeration date
10/24/2016
Last updated
06/30/2022
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