Jina Park

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

345112 Issued in TX

Practice address

9040 Jackson Ave
Attn: Achj-CLQ-C
Tacoma, WA 98433

Phone

(253) 986-0982

NPI assigned

Nov 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1508335209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9138 MIL PARK",
            "address_2": "108",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98433",
            "telephone_number": "213-663-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "address_2": "ATTN: ACHJ-CLQ-C",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98433",
            "telephone_number": "253-986-0982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "bldg 3370 evergreen ave",
            "address_2": "jblm",
            "address_purpose": "LOCATION",
            "city": "tacoma",
            "state": "WA",
            "postal_code": "98433",
            "country_code": "US",
            "telephone_number": "253-477-2766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "345112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hansol Christian Park, PHARM D
• Hoon Park, DC, L.AC
• Isabella Park
• Jason Park
• Jesse Park
• John Woongjoon Park, DMD
• Juyeon Park, MSW STUDENT
• Juyoung Park
• Lawrence Soo-Young Park, MD
• Matthew V. Park, M.D.

• Licensed Practical Nurse in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.