NPIMap

Individual provider Active NPI

Lawrence Soo-Young Park, MD

  • Diagnostic Radiology Physician
  • Tacoma, WA
National Provider Identifier
1871619122
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD60006965 Issued in WA
Practice address
1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone
(253) 761-4200
Fax
(253) 383-3553
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301082255 MI
Diagnostic Radiology Physician 2085R0202X MD162228 OR
Diagnostic Radiology Physician 2085R0202X MD60006965 WA Primary

Addresses

Primary practice location

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900

Mailing address

PO Box 1535
Tacoma, WA 98401-1535
Phone (253) 761-4200

Other identifiers 5

IdentifierTypeStateIssuer
0239075OtherWALABOR AND INDUSTRIES-TRA
8948507OtherWALABOR AND INDUSTRIES CRIME VICTIMS-TRA
8951845OtherWALABOR AND INDUSTRIES CRIME VICTIMS-MEDICAL IMAGING ON 1ST
0239076OtherWALABOR AND INDUSTRIES-UNION AVENUE OPEN MRI
0249563OtherWALABOR AND INDUSTRIES-MEDICAL IMAGING ON 1ST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080820000660 WA Practitioner - Diagnostic Radiology 9739276155 Reassigns benefits to 4 organizations
I20140411001806 OR Practitioner - Diagnostic Radiology 9739276155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tra-Minw P SGroup PAC ID 2163316167, 152 clinicians
Union Avenue Open MRI LLCGroup PAC ID 5597652917, 44 clinicians

Practice addresses (Care Compare)

1592 View Lake CT
Lake Oswego, OR 97034-3770
Phone (253) 761-4200

222 15TH Ave SE
Puyallup, WA 98372-3754
Phone (253) 841-4353

2502 S Union Ave
Tacoma, WA 98405-1328
Phone (253) 841-4353

2801 St Anthony Way
Pendleton, OR 97801-3800
Phone (253) 841-4353

34515 9TH Ave S
Federal Way, WA 98003-6761
Phone (253) 841-4353

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301082255MIMDDiagnostic Radiology Physician
MD162228ORMDDiagnostic Radiology Physician
MD60006965WAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Avenue Open MRI LLC CurrentSince Sep 1, 2008 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Mar 1, 2017 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Mar 1, 2017 Accepting new patients
Tra-Minw P S CurrentSince Sep 1, 2008 Accepting new patients
Tra Medical Imaging Centers LLC CurrentSince Dec 1, 2025 Accepting new patients
Mercer Island Medical Imaging, LLC PastSince Nov 1, 2009 Accepting new patients
Tra-Minw P S Past Accepting new patients
Commonspirit Washington Past Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance Past Accepting new patients
Doctors Clinic a Professional Corporation PastSince May 1, 2010 Accepting new patients

Locations

2801 St Anthony Way
Pendleton, OR 97801
Phone (541) 276-5121

122 3rd St NE
Auburn, WA 98002
Phone (253) 833-7750

21110 Sr 410 E
Ste 110
Bonney Lake, WA 98391

5900 State Highway 303 NE
Bremerton, WA 98311
Phone (253) 459-6633

2512 Wheaton Way
#O
Bremerton, WA 98310
Phone (360) 782-3700

2512 Wheaton Way
Bremerton, WA 98310
Phone (360) 782-3650

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

33915 1st Way S
Ste 130
Federal Way, WA 98003
Phone (253) 528-9135

4700 Point Fosdick Dr
Ste 110
Gig Harbor, WA 98335
Phone (253) 759-2622

9725 SE 36th St
Ste 114
Mercer Island, WA 98040

500 Lilly Rd NE
Ste 160
Olympia, WA 98506
Phone (360) 413-8307

222 15th Ave SE
Puyallup, WA 98372

11212 Sunrise Blvd E
Ste 200
Puyallup, WA 98374

3400 California Ave SW
Seattle, WA 98116
Phone (206) 320-3399

5919 100th St SW
Tacoma, WA 98499

1304 Fawcett Ave
Ste 100
Tacoma, WA 98402
Phone (253) 680-3372

3402 S 18th St
Tacoma, WA 98405
Phone (253) 383-1099

9601 Steilacoom Blvd SW
Tacoma, WA 98498
Phone (253) 582-8900

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

2502 S Union Ave
Tacoma, WA 98405
Phone (253) 759-5900

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ei-trami

Organizations & group practices 10

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 8

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1871619122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1535",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984011535",
            "telephone_number": "253-761-4200",
            "fax_number": "253-383-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021900",
            "telephone_number": "253-761-4200",
            "fax_number": "253-383-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "LAWRENCE",
        "middle_name": "SOO-YOUNG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301082255",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD162228",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60006965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES-TRA",
            "identifier": "0239075",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES CRIME VICTIMS-TRA",
            "identifier": "8948507",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES CRIME VICTIMS-MEDICAL IMAGING ON 1ST",
            "identifier": "8951845",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES-UNION AVENUE OPEN MRI",
            "identifier": "0239076",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES-MEDICAL IMAGING ON 1ST",
            "identifier": "0249563",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.