Individual provider · Type 1 NPI
Suah Park
Family Nurse Practitioner · Lakewood, WA
NPI number
1316563091
Active
Practice location
8725 S Tacoma Way
Lakewood, WA 98499-4544
Mailing address
5207 88th Street Ct SW Apt E207
Lakewood, WA 98499-3176
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 0001286995 (VA) |
| Family Nurse Practitioner Primary | 363LF0000X | AP61084806 (WA) |
| Family Nurse Practitioner | 363LF0000X | 0024179524 (VA) |
Family Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1316563091
Suah Park's National Provider Identifier is 1316563091, issued on Jun 18, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Lakewood, WA. The record was last updated on Jan 18, 2021.