Park, Jungwon Genevieve

Park, Jungwon Genevieve is an individual health care provider with primary practice located at 606 N Chelan Ave Ste B , Wenatchee WA 98801-2025. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic Surgery, Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery is her primary health care specialty. Park, Jungwon Genevieve can be contacted via phone (509) 596-0096.

Contact Information

Primary practice address
606 N Chelan Ave Ste B Wenatchee WA 98801-2025
Phone: (509) 596-0096
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X D0093570 Maryland
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X D0093570 Maryland

Profile Details

NPI number 1285080846
LBN Legal business name Park, Jungwon Genevieve
Credentials M.D., PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2016
Last updated Dec 31st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285080846 NPPES
Washington MEDICAID 2260815

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