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General NPI Number Information
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NPI Number | 1093471823
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Entity Type | Individual
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Provider Name | CHRISTOPHER JIN-SU PARK LMHC
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Gender | Male
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Dates
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Enumeration Date | 11/16/2021
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 3035 14TH AVE W APT 7
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City | SEATTLE
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State | WA
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Zip | 98119-2051
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Country | US
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Telephone | 206-530-4821
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Fax |
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Provider Business Mailing Address
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Address Line | 123 NW 36TH ST STE 210
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City | SEATTLE
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State | WA
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Zip | 98107-4959
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Country | US
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Telephone | 206-593-8968
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH61673954
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License Number State | WA
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