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General NPI Number Information
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NPI Number | 1326260969
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Entity Type | Individual
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Provider Name | WON KYU PARK LAC
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 3520 96TH ST S STE 115
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City | LAKEWOOD
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State | WA
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Zip | 98499-9251
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Country | US
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Telephone | 206-235-0669
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Fax | 253-507-4271
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Provider Business Mailing Address
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Address Line | 3520 96TH ST S STE 115
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City | LAKEWOOD
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State | WA
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Zip | 98499-9251
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Country | US
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Telephone | 206-235-0669
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Fax | 253-507-4271
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC00002798
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License Number State | WA
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