Patricia S. Park, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202-003368 Issued in VA

Practice address

3750 Joseph Siewick Dr
Fairfax, VA 22033-1742

Phone

(703) 391-1026

Fax

(703) 391-1027

NPI assigned

Aug 12, 2005

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287792000000",
    "number": "1164424883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 MAIN ST",
            "address_2": "SUITE 200A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313907",
            "telephone_number": "703-279-4394",
            "fax_number": "703-279-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 JOSEPH SIEWICK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331742",
            "telephone_number": "703-391-1026",
            "fax_number": "703-391-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "PATRICIA",
        "middle_name": "S.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2010-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202-003368",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "03053",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliana Youngmin Park, M.D.
• Lisa L Park, MD
• Makenna Park
• Min Park, NP
• Pamela Park, OTR
• Priscilla J Park
• Songki Park, NP
• Soo Woong Park, M.D.
• Allison Parker
• David A Parker, MD

• Speech-Language Pathologist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2010; 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.