Dennis Chai Sun Park I, MA/MS, CADCIII, CDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP00005610 Issued in WA

Practice address

1230 7TH Ave
Longview, WA 98632-3166

Phone

(180) 025-7200

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. Dennis Chai Sun Park I Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts, Master of Science

State licenses

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205916269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1562",
            "city": "WOODLAND",
            "state": "WA",
            "postal_code": "986741500",
            "telephone_number": "360-575-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 7TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323166",
            "telephone_number": "180-025-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "DENNIS",
        "middle_name": "CHAI SUN",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "MA/MS, CADCIII, CDP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00005610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHEMICAL DEPENDENCY WA",
            "identifier": "CP00005610",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENNIS",
            "last_name": "PARK",
            "middle_name": "CHAI SUN",
            "prefix": "MR.",
            "suffix": "I",
            "credential": "MA/MS, CADCIII, CDP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meggan Palmer
• Lydia Pane, DPT
• David Jude Paris, PMHNP-BC
• Andrew Jiho Park I, MA
• Ariel Rachel Park, DMD
• Dong-Wouk Park, MD
• Hannah Eunyoung Park, M.D.
• Molly Sue Isabelle Parr
• Randy Parr
• Kyle David Parsons

• Addiction (Substance Use Disorder) Counselor in Longview, WA
• Providers in Longview, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.