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1780621805
JAE O PARK
BEAVERTON, OR
NPI
1780621805
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: OR MD13752)
Enumeration Date
2006-05-31
Last Update Date
2017-02-24
Business Address
JAE O PARK MD
14455 SW ALLEN BLVD SUITE 101
BEAVERTON, OR 97005-4428
Phone number: 503-643-2120
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Mailing Address
JAE O PARK MD
12750 SW 2ND ST STE 101
BEAVERTON, OR 97005-2779
Phone number: 503-643-2120
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