EDMUND PARK (NPI# 1881146462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881146462 |
| Entity Type | Individual |
| Full Name | EDMUND PARK |
| Credential | M.DIV |
| Practice Address |
2915 E Madison St Suite 201 Seattle WA 98112-4265 |
| Practice Telephone | 2066595413 |
| Mailing Telephone | 2066595413 |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2016-10-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MC 60176362 | WA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | PREMERA BLUE CROSS | 777232A01NYJ | 01 |
| Street Address |
2915 E MADISON ST SUITE 201 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98112-4265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295801371 | Christopher Angus Lawrence | Psychiatry & Neurology | 2915 E Madison St, Suite 305, Seattle, WA 98112-4265 | 2006-11-28 |
| 1649799875 | Diane Marie Burgert | Counselor | 2915 E Madison St, Seattle, WA 98112-4265 | 2017-09-19 |
| 1700256526 | Leah Kangas | Massage Therapist | 2915 E Madison St, Suite 204, Seattle, WA 98112-4265 | 2015-10-06 |
| 1437539335 | Resilience A Physical Therapy and Pilates Studio | Clinic/Center | 2915 E Madison St, Suite 205, Seattle, WA 98112-4265 | 2015-06-05 |
| 1013306992 | Eighth Field Plcc | Clinic/Center | 2915 E Madison St, Suite 205, Seattle, WA 98112-4265 | 2015-01-15 |
| 1740558394 | Jorie D Wehrell | Marriage & Family Therapist | 2915 E Madison St, Suite 306, Seattle, WA 98112-4265 | 2011-12-11 |
| 1669740353 | Pamela Van Dalfsen, Ph.d., Inc., P.s. | Clinic/Center | 2915 E Madison St, Suite 300, Seattle, WA 98112-4265 | 2011-12-08 |
| 1780901546 | Deborah Kahn | Social Worker | 2915 E Madison St, Suite 200, Seattle, WA 98112-4265 | 2010-05-03 |
| 1629300413 | Mark Gramps | Counselor | 2915 E Madison St, Suite 300, Seattle, WA 98112-4265 | 2010-02-04 |
| 1891920294 | Carol Jean Poole | Counselor | 2915 E Madison St, #306, Seattle, WA 98112-4265 | 2009-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891254991 | Justin Jeng-young Fu | Student in an Organized Health Care Education/Training Program | 125 16 Th Ave E, Csb 545, Seattle, WA 98112 | 2019-03-18 |
| 1275015604 | Eyewear Gallery LLC | Optometrist | 3121 E. Madison St Ste 102, Seattle, WA 98112 | 2018-09-01 |
| 1336637081 | Oh Plastic and Reconstructive Surgery LLC | Plastic Surgery | 602 27th Ave E, Seattle, WA 98112 | 2018-04-27 |
| 1992228191 | John Joseph Folta | Chiropractor | 3121 E Madison St Ste 103a, Seattle, WA 98112 | 2017-07-19 |
| 1083161061 | Sheick Toure | Counselor | 122 16 Ave E, Seattle, WA 98112 | 2016-09-07 |
| 1457721805 | Jessica Donovan | Audiologist | 201 16th Ave E # Cmb, Seattle, WA 98112 | 2015-09-29 |
| 1952777427 | Ronald Berenson | Physiological Laboratory | 2032 41st Avenue, Seattle, WA 98112 | 2015-08-19 |
| 1225419005 | Adrienne Foley | Counselor | 1833 40th Ave. E., Seattle, WA 98112 | 2015-06-17 |
| 1952721771 | Ling Guo | Internal Medicine | Kaiser Permanente Central Hospital Building, 126 16th Ave E, Seattle, WA 98112 | 2014-04-19 |
| 1134548068 | Anne Gayman | Family Medicine | 125 16th Avenue East, Csb-540, Group Health Family Medicine Residency, Seattle, WA 98112 | 2014-04-08 |
| Find all providers in zip 98112 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407745 | Julie Mcgowan | Counselor | 9222 12th Ave Sw, Seattle, WA 98106-2908 | 2020-11-06 |
| 1043811292 | Satya Wellness Collective, LLC | Counselor | 5608 17th Ave Nw # 1063, Seattle, WA 98107-5232 | 2020-11-04 |
| 1366043960 | Nidhi Amy Rastogi | Counselor | 7004 Murray Ave Sw Apt 103, Seattle, WA 98136-1763 | 2020-11-02 |
| 1124628797 | Krista P Marceron | Counselor | 1421 34th Ave Ste 207, Seattle, WA 98122-3634 | 2020-10-31 |
| 1326648064 | Taylor Ferry | Counselor | 3954 1st Ave Ne Apt 3, Seattle, WA 98105-6863 | 2020-10-30 |
| 1710587969 | Brenton Brooks Page Jr. | Counselor | 819 N 49th St Ste 303, Seattle, WA 98103-6577 | 2020-10-27 |
| 1215536719 | Jessica Aarsvold | Counselor | 1 Ward St Unit 5, Seattle, WA 98109-3627 | 2020-10-26 |
| 1972102911 | Philip H Benjamin | Counselor | Philip Benjamin Seattle Psychology, Pllc 200 W. Mercer, Suite 111, Seattle, WA 98119 | 2020-10-21 |
| 1588263834 | Laura Gardener | Counselor | 216 25th Ave, Seattle, WA 98122-6104 | 2020-10-19 |
| 1265031512 | Mykel Ziolo | Counselor | 11700 Evanston Ave N, Seattle, WA 98133-8225 | 2020-10-19 |
| Find all providers in SEATTLE | ||||
Please comment or provide details below to improve the information on EDMUND PARK.
| 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.