Jerry W. Park, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OP00001729 Issued in WA

Practice address

9222 N Newport Hwy
Ste 1
Spokane, WA 99218-1235

Phone

(509) 467-4545

Fax

(509) 467-2304

NPI assigned

Sep 20, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• U.S. Healthworks Medical Group of Washington, PS

  • Urgent Care Clinic/Center
  • Valencia, CA
  • NPI 1407836208
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245337153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7511 N PANORAMA DR",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992088431",
            "telephone_number": "509-466-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9222 N NEWPORT HWY",
            "address_2": "STE 1",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181235",
            "telephone_number": "509-467-4545",
            "fax_number": "509-467-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JERRY",
        "middle_name": "W.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00001729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES NUMB",
            "identifier": "0151371",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "OP00001729",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Parisi, PT, DPT, CSCS
• Carolyn Parisot
• Michael A Parisot, MD
• Colby Christopher Park
• Hyung Uk Park, M.D.
• Joyce Ho Park, MD
• Louise Marie Park, LICSW
• Luciana Park
• Cyndi Parker-Parris, LMP
• Anna Elise Parker, MSW

• Family Medicine Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.