Individual provider Active NPI

Janice Haesun Park-Kwon, MD

  • Obstetrics & Gynecology Physician
  • Tualatin, OR
National Provider Identifier
1295398840
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD214718 Issued in OR
Practice address
19250 SW 65TH Ave Ste 300
Tualatin, OR 97062-7707
Phone
(503) 692-1242
Fax
(503) 691-3615
NPI assigned
Apr 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD214718 OR Primary

Addresses

Primary practice location

19250 SW 65TH Ave Ste 300
Tualatin, OR 97062-7707

Mailing address

7650 SW Beveland Rd Ste 200
Portland, OR 97223-8692
Phone (503) 601-3615

Other identifiers 1

IdentifierTypeStateIssuer
500824926MedicaidOR

Other names 1

  • Janice Haesun Park Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230912002500 OR Practitioner - Obstetrics/Gynecology 6709111396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Virginia School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Healthcare Associates LLCGroup PAC ID 8527054014, 103 clinicians

Practice addresses (Care Compare)

19250 SW 65TH Ave
Suite 300
Tualatin, OR 97062-7707
Phone (503) 692-1242

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD214718ORMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Healthcare Associates, LLC CurrentSince Oct 23, 2023 Accepting new patients
Northwest Urology, LLC Past Accepting new patients
Women'S Healthcare Associates, LLC PastSince Sep 3, 2025 Accepting new patients
Legacy Meridian Park Hospital Past Accepting new patients

Locations

1003 N Providence Dr
Ste 340
Newberg, OR 97132
Phone (503) 538-2698

7650 SW Beveland Rd
Ste 200
Portland, OR 97223
Phone (503) 601-3615

9701 SW Barnes Rd
Ste 200
Portland, OR 97225
Phone (503) 734-3700

19250 SW 65th Ave
Ste 300
Tualatin, OR 97062
Phone (503) 692-1242

Interoperability endpoints

  • Direct secure messaging: jpark1453905@direct.lhs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1295398840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7650 SW BEVELAND RD STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238692",
            "telephone_number": "503-601-3615",
            "fax_number": "503-646-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19250 SW 65TH AVE STE 300",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627707",
            "telephone_number": "503-692-1242",
            "fax_number": "503-691-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK-KWON",
        "first_name": "JANICE",
        "middle_name": "HAESUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-19",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD214718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500824926",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANICE",
            "last_name": "PARK",
            "middle_name": "HAESUN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tualatin, OR

Sources for this page

Verify at the official NPI Registry.