Doctor Name: | MS. SANGHEE DOROTHY PARK |
NPI Number: | 1376611632 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | A97511 |
Business Practice Address: | 1 Boone Rd Bremerton, WA - 983121894 |
Business Phone Number: | 3604754277 |
Business Fax Number: | |
Mailing Address: | 6108 Elaine Ct, BREMERTON |
State: | WA |
Postal Code: | 983122148 |
Phone Number: | 2069725177 |
Fax Number: | |
NPI Enumeration Date: | 12/02/2006 |
NPI Last Update Date: | 09/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A97511 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |