Provider Demographics
NPI:1477874311
Name:PARK, HYUNHEE (DO)
Entity Type:Individual
Prefix:
First Name:HYUNHEE
Middle Name:
Last Name:PARK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15906 MILL CREEK BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1797
Mailing Address - Country:US
Mailing Address - Phone:425-324-3494
Mailing Address - Fax:425-939-0807
Practice Address - Street 1:15906 MILL CREEK BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1797
Practice Address - Country:US
Practice Address - Phone:425-324-3494
Practice Address - Fax:425-939-0807
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60675086207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology