JUNGWON GENEVIEVE PARK M.D. PH.D. NPI 1285080846

NPI Information

NPI: 1285080846
Provider Name: JUNGWON GENEVIEVE PARK, M.D., PH.D.
Classification: Surgery - 2086S0122X
Entity Type: Individual

Specialization: Plastic and Reconstructive Surgery

PECOS Registration: Yes

Address:
606 N CHELAN AVE STE B
WENATCHEE, WA
ZIP 98801
Phone: (509) 596-0096
Get Directions

Jungwon Genevieve Park, M.D., PH.D. is a plastic and reconstructive surgery surgery in Wenatchee, WA with 8 years of experience. The provider is a surgeon who specializes in plastic and reconstructive surgery. Jungwon Genevieve Park, M.D., PH.D. NPI is 1285080846. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, AURORA
Graduation Year:2016

The provider's business location address is:

606 N CHELAN AVE STE B
WENATCHEE, WA
ZIP 98801-025
Phone: (509) 596-0096

The NPI 1285080846 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/12/2016 and was last updated on 12/31/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208200000X	Plastic Surgery		D0093570	MARYLAND	No
2	2086S0122X	Surgery	Plastic and Reconstructive Surgery	D0093570	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2260815	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »