Provider Demographics
NPI:1306393020
Name:PARK, HYELIM ANGELA (MSN, FNP-C, RN)
Entity Type:Individual
Prefix:
First Name:HYELIM
Middle Name:ANGELA
Last Name:PARK
Suffix:
Gender:F
Credentials:MSN, FNP-C, RN
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 3007
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98114-3007
Mailing Address - Country:US
Mailing Address - Phone:206-788-3500
Mailing Address - Fax:206-652-5216
Practice Address - Street 1:3815 S OTHELLO ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-3510
Practice Address - Country:US
Practice Address - Phone:206-788-3500
Practice Address - Fax:206-962-3298
Is Sole Proprietor?:No
Enumeration Date:2016-09-11
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60687150363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily