Kwang-Hie Park, MD, PLLC, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD-00045549 Issued in WA

Practice address

901 Boren Avenue
Suite 1020
Seattle, WA 98104-3508

Phone

(206) 682-8900

Fax

(206) 624-1489

NPI assigned

Apr 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Kwang Hie Park Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Cascade Psychiatric Services, PLLC

  • Specialist
  • Everett, WA
  • NPI 1841293735
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1073575601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 BOREN AVENUE",
            "address_2": "SUITE 1020",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043508",
            "telephone_number": "206-682-8900",
            "fax_number": "206-624-1489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 BOREN AVENUE",
            "address_2": "SUITE 1020",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043508",
            "telephone_number": "206-682-8900",
            "fax_number": "206-624-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK, MD, PLLC",
        "first_name": "KWANG-HIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD-00045549",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD-00045549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8439572",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8239572",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KWANG",
            "last_name": "PARK",
            "middle_name": "HIE",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Louise M Park, ARNP
• Luke C. Park, D.D.S.
• Marian Park, MD
• Marie Ayabe Park
• Matthias Park
• Min S Park, M.D.
• Nahee Park, MD
• Niya Park
• Noah Park
• Paul C Park, M.D.

• Child & Adolescent Psychiatry Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Child & Adolescent Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.