Dr. Frederick Park
Internist Gastroenterologist
4011 Talbot Rd S Ste 500
Renton
, Washington 98055-5773
Dr. Frederick Park
Internist Gastroenterologist
4011 Talbot Rd S Ste 500
Renton
, Washington 98055-5773
(425) 793-4707
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About
Features
Specialties
- Internist
- Gastroenterologist
Languages spoken
- English
Location
First Address
- Dr. Frederick Park
- Po Box 59028
- Renton, WA
- Zip : 98058-2028
- Fax : (425) 793-4707
- Phone : (425) 251-5110
Second Address
- Dr. Frederick Park
- 4011 Talbot Rd S Ste 500
- Renton, WA
- Zip : 98055-5773
- Fax : (425) 793-7380
- Phone : (425) 251-5110
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207R00000X | Internist | A106773 | CA |
| N | 111NI0900X | Internist | A106773 | CA |
| Y | 207RG0100X | Gastroenterologist | 60653608 | WA |
National Provider Identifier
| NPI | 1013113208 |
|---|---|
| Provider Name | Dr. Frederick Park |
| First Address | Renton, WA 98058-2028 |
| Second Address | Renton, WA 98055-5773 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/06/2007 |
| Last Update Date | 14/11/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 2061516 | (05) | WA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.