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1871113050
TED PARK
VANCOUVER, WA
NPI
1871113050
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: WA MD61411462)
Enumeration Date
2020-04-17
Last Update Date
2023-07-23
Business Address
TED PARK MD
501 SE 172ND AVE
VANCOUVER, WA 98684-9542
Phone number: 360-882-2778
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Mailing Address
TED PARK MD
PO BOX 4825
PORTLAND, OR 97208-4825
Phone number: 360-882-2778
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