JINA PARK (NPI# 1508335209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508335209 |
| Entity Type | Individual |
| Full Name | JINA PARK |
| Practice Address |
9040 Jackson Ave Attn: Achj-clq-c Tacoma WA 98433 |
| Mailing Address |
9138 Mil Park 108 Tacoma WA 98433 |
| Practice Telephone | 2539860982 |
| Mailing Telephone | 2136633164 |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2018-11-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 345112 | TX | Nursing Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Bldg 3370 Evergreen Ave, Jblm, Tacoma, WA 98433 | 2534772766 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487003505 | Jina Park | Psychiatry & Neurology | 462 1st Ave Fl 7, New York, NY 10016-9196 | 2016-06-09 |
| 1942776133 | Jina Park | Social Worker | 247 Prospect Ave Ste 4, Brooklyn, NY 11215-8403 | 2018-10-16 |
| 1306386354 | Jina Park | Registered Nurse | 1601 N Belt Line Rd Ste B, Mesquite, TX 75149-1791 | 2017-02-23 |
| 1093179517 | Jina Park | Student in an Organized Health Care Education/Training Program | 275 W Macarthur Blvd, Oakland, CA 94611-5641 | 2016-04-11 |
| Street Address |
9040 JACKSON AVE ATTN: ACHJ-CLQ-C |
| City | TACOMA |
| State | WA |
| Zip Code | 98433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356345185 | John E Buonora | Nurse Anesthetist, Certified Registered | 9040 Jackson Ave, Tacoma, WA 98431-2025 | 2005-06-09 |
| 1629675251 | Brian Rankin | Student in an Organized Health Care Education/Training Program | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-10-06 |
| 1508473869 | Allyssa Lynn Borak | Student in an Organized Health Care Education/Training Program | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-09-30 |
| 1093322299 | Jessica Granger | Student in an Organized Health Care Education/Training Program | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-09-30 |
| 1134736481 | Rebecca Reinhardt | Student in an Organized Health Care Education/Training Program | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-09-29 |
| 1184238479 | Mark Nash | Physical Therapist | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-09-03 |
| 1679191969 | Christopher A Land | Student in an Organized Health Care Education/Training Program | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-07-13 |
| 1396362604 | Valerie Kruger | Genetic Counselor, MS | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-07-02 |
| 1255958724 | Michael Wong | Student in an Organized Health Care Education/Training Program | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-07-01 |
| 1841813391 | Kailey Utley | Optometrist | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739881 | Bryonna Floyd | Dental Assistant | 11572 17th & C Street, Joint Base Lewis-mcchord, WA 98433 | 2020-08-07 |
| 1790393213 | Matthew T Ellison | Dentist | Dental Clinic 2, 3740 South 14th St., Joint Base Lewis-mcchord, WA 98433 | 2020-07-21 |
| 1952933251 | Julie Kristen Dutler | Dental Hygienist | 11572 C St, Jblm, WA 98433 | 2020-02-05 |
| 1881224806 | James Eric Carvelli | Dental Assistant | 11572 17th Street & C Street, Joint Base Lewis Mcchord, WA 98433 | 2020-01-17 |
| 1245891019 | Tanya Latrell Lesane | Counselor | 9924b W. Johnson St, Joint Base Lewis0mcchord, WA 98433 | 2019-06-24 |
| 1740844224 | Allison Tracy Bertoni | Student in an Organized Health Care Education/Training Program | 3740 South 14th Street, Joint Base Lewis-mcchord, WA 98433 | 2019-04-30 |
| 1124682448 | Lori Ann Sage | Registered Nurse | Building 11582, 17th & C Street, Joint Base Lewis-mcchord, WA 98433 | 2019-04-23 |
| 1639645997 | Emily Elisabeth Armstrong | Emergency Medical Technician, Paramedic | 3370 Evergreen Ave, Jblm, WA 98433 | 2018-10-15 |
| 1982182101 | Won Kyung Yang | Dentist | 11582 C St., Jblm, WA 98433 | 2018-07-31 |
| 1205325966 | Gloria Judith Penate I | Dental Hygienist | 2103 North Division Street, Tacoma, WA 98433 | 2018-05-08 |
| Find all providers in zip 98433 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922629427 | Helen Kigonya Babirye I | Licensed Practical Nurse | 9625 Croft St S, Tacoma, WA 98444-6533 | 2020-05-06 |
| 1346880267 | Lasana Lanell Bridges | Licensed Practical Nurse | 12720 C St S Apt E, Tacoma, WA 98444-1901 | 2020-01-08 |
| 1861051385 | Ashley Danielle Veal | Licensed Practical Nurse | 5001 S 56th St Ste J-o, Tacoma, WA 98409-1343 | 2019-06-08 |
| 1710545801 | Audrey Warman | Licensed Practical Nurse | 5313 110th St Sw, Tacoma, WA 98499-3529 | 2019-06-03 |
| 1528528247 | Kerrich Nicholson | Licensed Practical Nurse | 836 S Rochester St, Tacoma, WA 98465-1836 | 2019-03-20 |
| 1275097701 | Demetria House | Licensed Practical Nurse | 3727 S Tacoma Way, Tacoma, WA 98409-3134 | 2019-01-29 |
| 1609340660 | Carolyne Nderitu | Licensed Practical Nurse | 10202 Pacific Ave S Ste 210, Tacoma, WA 98444-6573 | 2019-01-13 |
| 1942770813 | Lance Edward Phillips | Licensed Practical Nurse | 3629 S D St # 1119211, Tacoma, WA 98418-6813 | 2018-12-04 |
| 1003301813 | Melissa Nichole Nash | Licensed Practical Nurse | Madigan Army Medical Center 9040 Jackson Ave Attn: Mch, Tacoma, WA 98431-0001 | 2018-06-25 |
| 1922506641 | Paul Hamrick | Licensed Practical Nurse | Madigan Army Medical Center Taco 9140 Jackson Ave Attn:, Tacoma, WA 98431-0001 | 2018-01-28 |
| Find all providers in TACOMA | ||||
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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.