| NPI | 1396447876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUNGWON GENEVIEVE PARK Member 509-596-0096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2026-01-28 |