DR. SONG YOUN PARK (NPI# 1376173328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376173328 |
| Entity Type | Individual |
| Full Name | DR. SONG YOUN PARK |
| Credential | MD |
| Practice Address |
4225 Roosevelt Way Ne Fl 4 Seattle WA 98105-6099 |
| Mailing Address |
19130 Se 47th Pl Issaquah WA 98027-9315 |
| Practice Telephone | 2065435290 |
| Mailing Telephone | 4252700391 |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2020-01-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 61010637 | WA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902288434 | Song Anthimus Park | Optometrist | 13593 Us Highway 87 W # 105, La Vernia, TX 78121-5884 | 2015-06-20 |
| 1568852317 | Song Y. Park | Nurse Practitioner | 771 Old Norcross Rd Ste 120, Lawrenceville, GA 30046-4977 | 2015-02-02 |
| 1346761541 | Song Park | Acupuncturist | 16 E 40th St Fl 2, New York, NY 10016-0134 | 2017-06-28 |
| 1225486947 | Song Yong Park | Dentist | 412 State Route 37, Hogansburg, NY 13655-3109 | 2016-06-03 |
| 1811297971 | Song Wook Park | Pharmacist | 413 Elden St, Herndon, VA 20170-4512 | 2010-10-23 |
| Street Address |
4225 ROOSEVELT WAY NE FL 4 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98105-6099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306818513 | Miroslav Backonja | Psychiatry & Neurology | 4225 Roosevelt Way Ne Fl 4, Seattle, WA 98105-6099 | 2006-02-02 |
| 1477907822 | Melissa Osborn | Physical Medicine & Rehabilitation | 4225 Roosevelt Way Ne Fl 4, Seattle, WA 98105-6099 | 2016-04-21 |
| 1619394780 | Ata S Moshiri | Dermatology | 4225 Roosevelt Way Ne Fl 4, Seattle, WA 98105-6099 | 2014-03-26 |
| 1215047527 | Catherine Q Howe | Psychiatry & Neurology | 4225 Roosevelt Way Ne Fl 4, Seattle, WA 98105-6099 | 2006-08-30 |
| 1003844226 | Brett Russell Stacey | Anesthesiology | 4225 Roosevelt Way Ne Fl 4, Seattle, WA 98105-6099 | 2006-06-28 |
| 1194764837 | Kendra Gail Bergstrom | Dermatology | 4225 Roosevelt Way Ne Fl 4, Seattle, WA 98105-6099 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326662396 | Dale Justin Podolsky | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Ob.9.520, Seattle Children's, Seattle, WA 98105 | 2020-06-04 |
| 1376170878 | Andrew Crompton Yazman | Pediatrics | 4800 Sand Point Way, Ne Oc.7.830, Seattle, WA 98105 | 2020-03-25 |
| 1427688845 | Daniela Michell Zepeda | Behavioral Analyst | 4616 25th Ave Ne Pmb 437, Seattle, WA 98105 | 2020-01-24 |
| 1255981189 | Emily King | Student in an Organized Health Care Education/Training Program | Mark Hawkins, Pa-c, Mpas, 4311 11th Ave Ne Suite 200, WA 98105 | 2019-09-12 |
| 1821659327 | Sara Katherine Horne | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Mb.11.500, Department of Anesthesiology and Pain Medicine, Seattle, Seattle, WA 98105 | 2019-06-25 |
| 1881252575 | Darryl Lee Wright | Peer Specialist | Gossett Place, 4719 12th Ave Ne, Seattle, WA 98105 | 2019-05-29 |
| 1487117891 | Nirupama Madhavan | Behavioral Analyst | 5001 25th Ave Ne, Seattle, WA 98105 | 2019-04-11 |
| 1780155648 | Eryn R Mcentee | Naturopath | 2216 Ne46th St, Seattle, WA 98105 | 2018-12-17 |
| 1356811921 | Kyle Leland Bernbach | Massage Therapist | 5224 Ravenna Ave Ne, Seattle, WA 98105 | 2018-11-27 |
| 1548742380 | Janal Kim | Physician Assistant | 4726 11th Ave Ne, Apt 511, Seattle, WA 98105 | 2018-08-29 |
| Find all providers in zip 98105 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093158305 | Erica Shantha Tarabadkar | Dermatology | 850 Republican Street, Brotman Room 242, Uw Medical Center At Lake Union, Seattle, WA 98109 | 2013-04-17 |
| 1578839494 | Carolina Andrea Simunovic | Dermatology | 1959 Ne Pacific St Rm Bb-1353, Box 356524, Seattle, WA 98195-6524 | 2012-03-25 |
| 1184999260 | April Schachtel | Dermatology | 1660 S Columbian Way Va Puget Sound Health Care System, General Internal Medicine Clinic, Seattle, WA 98108 | 2012-03-21 |
| 1831362045 | James Hu Md PC | Dermatology | 1229 Madison St Ste 830, Seattle, WA 98104-3539 | 2008-04-09 |
| 1437277993 | James Hu | Dermatology | 1229 Madison St - Ste #830, Seattle, WA 98104-3579 | 2007-03-26 |
| 1497884506 | Roy Mitchell Colven | Dermatology | 325 9th Ave, Dermatology Section, Seattle, WA 98115 | 2007-03-05 |
| 1164585600 | Gerald Bernstein | Dermatology | 11011 Meridian Av North, Suite 102, Seattle, WA 98133 | 2006-12-18 |
| 1720170723 | Jettie M Person | Dermatology | 3834 49th Ave Ne, Seattle, WA 98105-5234 | 2006-09-28 |
| 1164533048 | James Corydon Vary Jr. | Dermatology | Box 354697, 4225 Roosevelt Way Ne - 4th Floor, Seattle, WA 98105 | 2006-08-31 |
| 1033127717 | Ardeth Lazz Dunne | Dermatology | 1730 Minor Avenue, Ste 1000 Dermatology Associates Pllc, Seattle, WA 98101-1498 | 2006-08-04 |
| Find all providers in SEATTLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.