JISUN PARK (NPI# 1669097572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669097572 |
| Entity Type | Individual |
| Full Name | JISUN PARK |
| Practice Address |
747 Broadway Seattle WA 98122-4379 |
| Mailing Address |
130 Ne 95th St Apt A307 Seattle WA 98115-2056 |
| Practice Telephone | 2027142893 |
| Mailing Telephone | 2027142893 |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2020-06-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 86064132 | WA | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114270162 | Jisun Park | Speech-Language Pathologist | 816 Ne 190th St, Shoreline, WA 98155-2249 | 2012-10-15 |
| 1386945459 | Jisun Park | Counselor | 750 Broadway Ave E, Mattoon, IL 61938-4610 | 2010-11-05 |
| Street Address |
747 BROADWAY |
| City | SEATTLE |
| State | WA |
| Zip Code | 98122-4379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215935960 | Marilee M. Jensen | Registered Nurse | 747 Broadway, Seattle, WA 98122-4379 | 2005-07-07 |
| 1366058919 | Mairghread Foley | Registered Nurse | 747 Broadway, Seattle, WA 98122-4307 | 2020-09-18 |
| 1891301628 | Jessica C Kelley | Registered Nurse | 747 Broadway, Seattle, WA 98122-4307 | 2020-09-17 |
| 1972116010 | Lindsey Gervascio | Registered Nurse | 747 Broadway, Seattle, WA 98122-4379 | 2020-08-28 |
| 1023633187 | Hang Hoang-nguyen | Pharmacist | 747 Broadway, Seattle, WA 98122-4307 | 2020-06-14 |
| 1558981357 | Caitlin Elizabeth Busbee | Student in an Organized Health Care Education/Training Program | 747 Broadway, Seattle, WA 98122-4307 | 2020-04-21 |
| 1164041323 | Emma Ludesi Makoba | Student in an Organized Health Care Education/Training Program | 747 Broadway, Seattle, WA 98122-4379 | 2020-04-08 |
| 1043849375 | Kaitlin Jane Byerly | Student in an Organized Health Care Education/Training Program | 747 Broadway, Seattle, WA 98122-4307 | 2020-04-07 |
| 1649809161 | Jia Hui Wang | Student in an Organized Health Care Education/Training Program | 747 Broadway, Seattle, WA 98122-4307 | 2020-04-06 |
| 1750910485 | Aisling Shi Zhao | Student in an Organized Health Care Education/Training Program | 747 Broadway, Seattle, WA 98122-4307 | 2020-04-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938506 | Quality Counseling and Consultation Service LLC | Counselor | 1525 Harvard Ave #509, Seattle, WA 98122 | 2020-07-01 |
| 1912535626 | Cesar Andrade | Student in an Organized Health Care Education/Training Program | 550 16th Avenue #400, Seattle, WA 98122 | 2020-03-29 |
| 1366089666 | Peter Nguyen | Pharmacy Technician | 914 East Jefferson Street, Campion Hall, Seattle, WA 98122 | 2019-12-05 |
| 1356903140 | Jason Dandino | Specialist/Technologist | 550 14th Avenue, Seattle, WA 98122 | 2019-07-02 |
| 1962066415 | Seattle Colleges | Local Education Agency (LEA) | Mainstay At Seattle Central College, 1701 Broadway Ms Be3210, Seattle, WA 98122 | 2019-04-30 |
| 1538621412 | Mitchell R Ornelas | Student in an Organized Health Care Education/Training Program | Swedish Family Medicine Residency Cherry Hill; 550 16th, Avenue #400, Seattle, WA 98122 | 2019-04-01 |
| 1003374265 | Michael Russell | Surgery | 747 Broadway Heath Building 10th Floor, Seattle, WA 98122 | 2019-03-06 |
| 1639646821 | Maritza E Cajiao | Doula | 747 Broadway, Seattle, Seattle, WA 98122 | 2018-10-25 |
| 1336616762 | Suzanna M Lovin | Social Worker | 401 Broadway, 1st Floor, Seattle, WA 98122 | 2018-10-24 |
| 1184137770 | Walter Franklin Krengel Jr. | Orthopaedic Surgery | 2000 1st Ave Suite 2201, Seattle, WA 98122 | 2017-11-06 |
| Find all providers in zip 98122 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679949 | Renewtrition, LLC | Dietitian, Registered | 4239 Evanston Ave N, Seattle, WA 98103-7206 | 2020-11-03 |
| 1144821620 | Sydney Marie Carroll | Dietitian, Registered | 1818 E Mercer St Ste 103, Seattle, WA 98112-4689 | 2020-11-03 |
| 1679170096 | Taisha Bell | Dietitian, Registered | 300 1st Ave W Apt 303, Seattle, WA 98119-4375 | 2020-10-08 |
| 1225645427 | Virginia A Turner | Dietitian, Registered | 434 Ne 73rd St Apt 1/2, Seattle, WA 98115-5331 | 2020-09-30 |
| 1326653734 | Julie Duli Kim | Dietitian, Registered | 4220 S Trenton St, Seattle, WA 98118-4921 | 2020-09-11 |
| 1750996252 | Geneva Curry | Dietitian, Registered | 3006 Nw Market St Apt 5, Seattle, WA 98107-4222 | 2020-09-10 |
| 1679187066 | Sara C Woolcock | Dietitian, Registered | 1800 15th Ave S Unit B, Seattle, WA 98144-4214 | 2020-09-02 |
| 1275150773 | Miranda Duffy Eriksen | Dietitian, Registered | 4235 Francis Ave N Apt 204, Seattle, WA 98103-7126 | 2020-06-30 |
| 1790302610 | Clare Bawden | Dietitian, Registered | 7408 28th Ave Nw, Seattle, WA 98117-5951 | 2020-06-26 |
| 1366068744 | Tracey Kmiecik | Dietitian, Registered | 5450 Leary Ave Nw Apt 643, Seattle, WA 98107-4081 | 2020-06-22 |
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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.