Active NPI
Ji-Young Park
- Pharmacist
- Port Angeles, WA
National Provider Identifier
1043651086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH90277923
- Practice address
- 932 E Front St
Port Angeles, WA 98362-4015 - Phone
- (360) 457-4456
- NPI assigned
- Jul 6, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH90277923 | WA | Primary |
Addresses
Primary practice location
932 E Front St
Port Angeles, WA 98362-4015
Mailing address
932 E Front St
Port Angeles, WA 98362-4015
Phone (360) 457-4456
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH90277923 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373068800000",
"number": "1043651086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "932 E FRONT ST",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983624015",
"telephone_number": "360-457-4456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "932 E FRONT ST",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983624015",
"telephone_number": "360-457-4456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "JI-YOUNG",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-06",
"last_updated": "2013-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH90277923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Angeles, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.