Individual provider Active NPI

Samuel Sung Uk Park

  • Optometrist
  • Tacoma, WA
National Provider Identifier
1871392159
Registry record updated Jun 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
70147553 Issued in WA
Practice address
9600 Veterans Dr SW
Tacoma, WA 98493-0003
Phone
(253) 583-1250
NPI assigned
Mar 10, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 70147553 WA Primary

Addresses

Primary practice location

9600 Veterans Dr SW
Tacoma, WA 98493-0003

Mailing address

9600 Veterans Dr SW
Tacoma, WA 98493-0003
Phone (253) 583-1250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782518400000",
    "number": "1871392159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 VETERANS DR SW",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984930003",
            "telephone_number": "253-583-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 VETERANS DR SW",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984930003",
            "telephone_number": "253-583-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SAMUEL",
        "middle_name": "SUNG UK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-10",
        "last_updated": "2026-06-27",
        "certification_date": "2026-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "70147553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2026; 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.