Individual
DR. PETER K PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3909 9TH AVE SW, OLYMPIA, WA 98502-5134
(360) 570-3460
Mailing address
3909 9TH AVE SW, OLYMPIA, WA 98502-5134
(314) 362-5000
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
2023000432
MO
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
OP61483972
WA
390200000X
Student in an Organized Health Care Education/Training Program
2020011741
MO
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/29/2019
Last updated
06/24/2024
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