Park, Matthew V.

Park, Matthew V. is an individual health care provider with primary practice located at 603 S J St Ste 102 , Tacoma WA 98405-4100. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as his primary health care specialty. Park, Matthew V. can be contacted via phone (253) 396-4868.

Contact Information

Primary practice address
603 S J St Ste 102 Tacoma WA 98405-4100
Phone: (253) 396-4868
Fax: (253) 396-4870
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 48231 Wisconsin
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X MD 00049264 Washington

Profile Details

NPI number 1699875716
LBN Legal business name Park, Matthew V.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Oct 25th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699875716 NPPES
Washington MEDICAID 1092505

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