Lighthouse Pediatric Medicine PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

LIGHTHOUSE PEDIATRIC MEDICINE PLLC

Doing business as

Lighthouse Pediatrics

Practice address

1505 NW Gilman Blvd Ste 8
Issaquah, WA 98027-5398

Phone

(425) 243-3599

NPI assigned

Sep 26, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Sung Park, MDNPI 1215103171

Title

Managing Member, Physician, Owner

Phone

(425) 243-3599

Specialties & licenses 1

Addresses

Other names 1

• Lighthouse Pediatrics Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sung Eun Park, MD

  • Pediatrics Physician
  • Issaquah, WA
  • NPI 1215103171
  NPD Authorized official

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1336967611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 NW GILMAN BLVD STE 8",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275398",
            "telephone_number": "425-243-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 NW GILMAN BLVD STE 8",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275398",
            "telephone_number": "425-243-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE PEDIATRIC MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SUNG",
        "authorized_official_title_or_position": "MANAGING MEMBER, PHYSICIAN, OWNER",
        "authorized_official_telephone_number": "425-243-3599",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Lichtenwalter, DC
• Nicholas S Liddick
• Valerie Sanchez Liebhaber, D.D.S.
• Lifetime Wellness Chiropractic Inc
• Laureen Light, PH.D.
• Gina Lightner
• Faith McDevitt Liikala, R.PH.
• Chih Ying Lin
• Eric M Lin
• Jasmine Lin

• Pediatrics Physician in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.