Individual
MINYOUNG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10151 SE SUNNYSIDE RD STE 100, CLACKAMAS, OR 97015-5705
(503) 659-0880
Mailing address
10151 SE SUNNYSIDE RD STE 100, CLACKAMAS, OR 97015-5705
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1180781
VA
363A00000X
Physician Assistant
Primary
PA214629
OR
Other
Enumeration date
01/09/2023
Last updated
12/19/2023
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