Jamie Lee Park, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

P6063 Issued in ID

Practice address

700 W Ironwood Dr
Coeur D Alene, ID 83814-2656

Phone

(208) 625-5688

Fax

(208) 625-5687

NPI assigned

Aug 21, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503273600000",
    "number": "1033635180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11411 N TRAFALGAR ST",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359134",
            "telephone_number": "208-215-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142656",
            "telephone_number": "208-625-5688",
            "fax_number": "208-625-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JAMIE",
        "middle_name": "LEE",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-21",
        "last_updated": "2017-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P6063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Panhandle Behavioal Health
• Amanda Michele Pankratz
• Craig James Panos, M. D.
• Erica Lynn Panttaja, APRN
• Patrick John Parden, M.D.
• Kristin Park, MSMFT, LMFT
• Travis Anthony Park, PHARMD.
• Courtney L Parker, NP
• David Parker, MD
• Hinah Gul Parker

• Pharmacist in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.