Individual provider Active NPI

Ye Jin Park, PA-C

  • Physician Assistant
  • Everett, WA
National Provider Identifier
1205450863
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MP7840398 Issued in WA
Practice address
3901 Hoyt Ave
Everett, WA 98201-4918
Phone
(425) 339-5411
NPI assigned
May 29, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MP7840398 WA Primary
Surgical Physician Assistant 363AS0400X PA61370219 WA

Addresses

Primary practice location

3901 Hoyt Ave
Everett, WA 98201-4918

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Other practice location 1

8923 Soper Hill Rd
Marysville, WA 98270-6882
Phone (206) 860-5414

Other practice location 2

550 17th Ave Ste 500
Seattle, WA 98122-5789
Phone (206) 320-2800

Other practice location 3

11800 NE 128th St Fl 5
Kirkland, WA 98034-7208
Phone (206) 860-5414

Other practice location 4

2901 174th St NE
Marysville, WA 98271-4743
Phone (360) 454-1900

Other identifiers 1

IdentifierTypeStateIssuer
2238005MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230130001811 WA Practitioner - Physician Assistant 7810368867 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

1330 Rockefeller Ave
Everett, WA 98201-1684
Phone (425) 259-0966

3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 339-5442

3927 Rucker Ave
Everett, WA 98201-4833
Phone (425) 259-0966

Merit-based Incentive Payment System (MIPS)

Final score
87.1 of 100Reported as group
Quality
84.53
Promoting interoperability
100
Improvement activities
40
Cost
72.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61370219WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC CurrentSince Feb 10, 2026 Accepting new patients
Optum Care Washington PLLC CurrentSince Feb 10, 2025 Accepting new patients
The Polyclinic PLLC CurrentSince Feb 10, 2026 Accepting new patients
Optum Care Washington PLLC CurrentSince Feb 10, 2025 Accepting new patients
Swedish Health Services Past Accepting new patients
The Polyclinic PLLC Past Accepting new patients
Optum Care Washington PLLC Past Accepting new patients

Locations

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

3901 Hoyt Ave
Everett, WA 98201
Phone (425) 258-3903

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1600 E Jefferson St
Ste 101
Seattle, WA 98122
Phone (206) 320-3100

9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777

1145 Broadway
Seattle, WA 98122

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

1812 S J St
Ste 102
Tacoma, WA 98405
Phone (253) 552-4900

Interoperability endpoints

  • Direct secure messaging: ypark94564@direct.tecmc.com
  • Direct secure messaging: ypark1831262@wm.providencedirect.org

Organizations & group practices 9

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": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1205450863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 HOYT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014918",
            "telephone_number": "425-339-5411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8923 Soper Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "WA",
            "postal_code": "982706882",
            "country_code": "US",
            "telephone_number": "206-860-5414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 17th Ave Ste 500",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981225789",
            "country_code": "US",
            "telephone_number": "206-320-2800",
            "fax_number": "206-320-2827",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11800 NE 128th St Fl 5",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980347208",
            "country_code": "US",
            "telephone_number": "206-860-5414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2901 174th St NE",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "WA",
            "postal_code": "982714743",
            "country_code": "US",
            "telephone_number": "360-454-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "YE",
        "middle_name": "JIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "MP7840398",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61370219",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2238005",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.