Search › Washington › 171M00000X
Jesse Park
NPI 1407502107 · on the registry since 2022
Practice
- Address
- 610 S Yakima Ave
Tacoma, WA 98405 - Phone
- (253) 396-5823
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 171M00000X
171M00000X
- Licence states on file
- WA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-02-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington