Active NPI
Sohyun Park
- Pharmacist
- Omak, WA
National Provider Identifier
1952964579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60896394
- Practice address
- 617 Benton St
Omak, WA 98841-9636 - Phone
- (509) 422-7735
- NPI assigned
- Apr 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60896394 | WA | Primary |
Addresses
Primary practice location
617 Benton St
Omak, WA 98841-9636
Mailing address
18414 104TH Ave NE Apt 104
Bothell, WA 98011-3465
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH60896394 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555545600000",
"number": "1952964579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18414 104TH AVE NE APT 104",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980113465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "617 BENTON ST",
"city": "OMAK",
"state": "WA",
"postal_code": "988419636",
"telephone_number": "509-422-7735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "SOHYUN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-18",
"last_updated": "2019-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60896394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omak, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.