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NPI Code Detail

MEDICARE: DR. JAMES S PARK D.C.

MEDICARE: DR. JAMES S PARK D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCH00034032WA

General Provider Information

NPI Number : 1912014366
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES S PARK D.C.
Provider Business Mailing Address
First Line : 15027 AURORA AVE N
Second Line :
City : SHORELINE
State : WA
Zip : 98133-6134
Country : US
Telephone Number : 206-362-3520
Fax Number : 206-362-3521
Provider Business Practice Location Address
First Line : 15027 AURORA AVE N
Second Line :
City : SHORELINE
State : WA
Zip : 98133-6134
Country : US
Telephone Number : 206-362-3520
Fax Number : 206-362-3521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JAMES S PARK D.C.” Practice Location

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