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General NPI Number Information
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NPI Number | 1205949195
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Entity Type | Individual
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Provider Name | WILLIAM Y PARK MD
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Gender | Male
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 08/14/2017
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Provider Practice Location Address
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Address Line | 4011 TALBOT RD S STE 460
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City | RENTON
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State | WA
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Zip | 98055-5773
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Country | US
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Telephone | 425-251-5110
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Fax | 425-793-7382
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Provider Business Mailing Address
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Address Line | PO BOX 50010
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City | RENTON
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State | WA
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Zip | 98058-5010
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Country | US
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Telephone | 425-228-3440
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | MD00036260
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | MD00036260
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | MD00036260
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License Number State | WA
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