Jewel Park, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD61606820 Issued in WA

Practice address

1701 N 13TH St
Shelton, WA 98584-2077

Phone

(360) 426-2653

NPI assigned

Apr 6, 2022

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

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Public Hospital District No 1 of Mason County

  dba Mason Health-Mason General Hospital

  • Critical Access Hospital
  • Shelton, WA
  • NPI 1760568752
  Medicare reassignment NPD
• Public Hospital District No 1 of Mason County

  dba Mason Health Hoodsport Primary Care

  • Clinic/Center
  • Hoodsport, WA
  • NPI 1548699408
  NPD
• Public Hospital District No 1 of Mason County Wa

  dba Mason General Hospital Mountain View Women's Health

  • Clinic/Center
  • Shelton, WA
  • NPI 1316174774
  NPD

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1780325381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 N 13TH ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842077",
            "telephone_number": "360-426-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N 13TH ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842077",
            "telephone_number": "360-426-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JEWEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-06",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD61606820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Preston Outen
• Joel Owens
• Deanna Paige
• Shannon L Paine, RN
• Kaylesh K. Pandya, D.O.
• Rachel Jean Parker, CPC
• Jalen M Parrott
• Krystal Marie Pate
• Chandrakant Shivarambhai Patel, PHARMACIST
• Patrick Kwong P.S.

• Pediatrics Physician in Shelton, WA
• Providers in Shelton, 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 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.