DR. YONGMOON ANDREW PARK (NPI# 1154334670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154334670 |
| Entity Type | Individual |
| Full Name | DR. YONGMOON ANDREW PARK |
| Credential | MD |
| Practice Address |
1012 S 3rd St Dayton WA 99328-1606 |
| Practice Telephone | 5093823200 |
| Practice Fax Number | 5093822748 |
| Mailing Telephone | 5093823200 |
| Mailing Fax Number | 5093822748 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2012-12-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MD60173758 | WA | Other Service Providers |
| N | 207Q00000X | Family Medicine | A48817 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1012 S 3RD ST |
| City | DAYTON |
| State | WA |
| Zip Code | 99328-1606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104475243 | Jennifer Lea Burnett | Nurse Practitioner | 1012 S 3rd St, Dayton, WA 99328-1696 | 2019-09-11 |
| 1376072553 | Melissa Rene Czapka | Nurse Practitioner | 1012 S 3rd St, Dayton, WA 99328-1606 | 2017-06-09 |
| 1275733560 | Laurence A Eidt | Family Medicine | 1012 S 3rd St, Dayton, WA 99328-1606 | 2007-07-24 |
| 1861691917 | Columbia County Hospital District | General Acute Care Hospital | 1012 S 3rd St, Dayton, WA 99328-1606 | 2007-07-17 |
| 1447476056 | Kenneth Hunt Coleman | Emergency Medicine | 1012 S 3rd St, Dayton, WA 99328-1606 | 2007-04-18 |
| 1184712739 | Kenneth Dyball | Family Medicine | 1012 S 3rd St, Dayton, WA 99328-1606 | 2006-10-10 |
| 1235227893 | Lynette Hamman | Family Medicine | 1012 S 3rd St, Dayton, WA 99328-1606 | 2006-10-10 |
| 1003904640 | Michael Luce | Family Medicine | 1012 S 3rd St, Dayton, WA 99328-1606 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487736153 | County of Columbia | Public Health or Welfare | 1002 S 3rd Street, Ste 2, Dayton, WA 99328 | 2006-10-20 |
| 1134128911 | Columbia County Hospital District | Clinic/Center | 1012 South Third Street, Dayton, WA 99328 | 2005-07-14 |
| 1619454030 | Tasha L Willoughby | Counselor | 1012 South Third Street, Dayton, WA 99328 | 2018-07-27 |
| 1821500299 | Bruce Wayne Pollard | Social Worker | 1012 South Third Street, Dayton, WA 99328 | 2017-10-25 |
| 1811307382 | Kimberly Greene | Speech-Language Pathologist | 1012 South Third Street, Dayton, WA 99328 | 2014-05-05 |
| 1689841892 | Rebekah R Gustin | Occupational Therapist | 1012 South Third Street, Dayton, WA 99328 | 2008-05-15 |
| 1932286077 | Columbia County Hospital District | Medicare Defined Swing Bed Unit | 1012 South Third Street, Dayton, WA 99328 | 2006-11-01 |
| 1518044551 | Columbia County Hospital District | Clinic/Center | 1012 South Third Street, Dayton, WA 99328 | 2006-11-01 |
| 1659458610 | Columbia County Hospital District | Skilled Nursing Facility | 1012 South Third Street, Dayton, WA 99328 | 2006-11-01 |
| 1023193828 | Kim Irene Emery | Physician Assistant | 1012 South Third Street, Dayton, WA 99328 | 2006-10-27 |
| Find all providers in zip 99328 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497384333 | Robert Rider | Specialist | 2077 Miamisburg Centerville Rd, Dayton, OH 45459-3846 | 2020-04-03 |
| 1164829446 | Christopher Randall | Specialist | 124 Murray Dr, Dayton, OH 45403-2846 | 2014-12-02 |
| 1164845798 | Terri Dinkelaker | Specialist | 200 S. Keowe St, Dayton, OH 45402-2854 | 2014-02-03 |
| 1629212568 | Paula Kay Baker | Specialist | 349 S. Main St., Dayton, OH 45402 | 2009-04-22 |
| 1104065275 | Dayton Cardiology and Vasc Cons Inc | Specialist | 301 W 1st St Ste 100, Dayton, OH 45402-3046 | 2009-02-13 |
| 1538352596 | Michelle Hoffman | Specialist | 7413 Bunker Ct, Dayton, OH 45459-4201 | 2007-08-23 |
| 1871795179 | Geneva Esquiline Carnahan | Specialist | 4598 Arcadia Blvd, Dayton, OH 45432-3108 | 2007-05-31 |
| 1891903324 | Susan Carol Robinson | Specialist | 265 E Whipp Rd, Dayton, OH 45459-2105 | 2007-05-18 |
| 1225241029 | Dayton Occupational Medical Center Ltd | Specialist | 2597 Needmore Rd, Dayton, OH 45414-4203 | 2007-05-08 |
| 1730205030 | Danny L Reveal, M.d., Inc. | Specialist | 2300 Far Hills Ave, Dayton, OH 45419-1550 | 2007-03-21 |
| Find all providers in DAYTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.