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TIMOTHY PARK
NPI 1457190738
Student in an Organized Health Care Education/Training Program in Seattle, WA

Active since May 24, 2024PECOS Enrolled
1959 NE PACIFIC STREET; BOX 357134, SEATTLE, WA 98195(215) 285-5142 Get Directions Write a Review

NPPES record last updated: October 1, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Timothy Park NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIMOTHY PARK (NPI 1457190738) is an individual student in an organized health care education/training program in Seattle, Washington, licensed in Washington (DE61681113) and active in the NPI registry since May 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457190738
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameTIMOTHY PARK
Location Address1959 NE PACIFIC STREET; BOX 357134Seattle, WA 98195-1463
Mailing Address1959 Ne Pacific Street; Box 357134Seattle, WA 98195-0001 · (215) 285-5142
Phone(215) 285-5142
Sole ProprietorNo
Enumeration DateMay 24, 2024
Last NPPES UpdateOctober 1, 2025
NPPES CertifiedOctober 1, 2025
✔ NPI 1457190738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in WA · DE61681113
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1959 NE PACIFIC STREET; BOX 357134, Seattle, WA 98195
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Timothy Park is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JIAXIN YUAN
Oral & Maxillofacial Surgery
1959 NE PACIFIC STREET; BOX 357134
SEATTLE, WA 98195
King County (206) 543-7496
CHRISTOPHER S CARLSON DDS
Dentist
1959 NE PACIFIC STREET; BOX 357134, UNIVERSITY OF WASHINGTON DEPARTMENT OF ORAL SURGERY
SEATTLE, WA 98195
King County (520) 661-9145
ANDREW NGUYEN
Oral & Maxillofacial Surgery
1959 NE PACIFIC STREET; BOX 357134
SEATTLE, WA 98195
King County (408) 833-4364
MR. JULIAN CHRISTOPHER MEILLEUR
Oral & Maxillofacial Surgery
1959 NE PACIFIC STREET; BOX 357134
SEATTLE, WA 98195
King County (504) 952-2138
SHAWN KENNETH GRIFFIN
Oral & Maxillofacial Surgery
1959 NE PACIFIC STREET; BOX 357134
SEATTLE, WA 98195
King County (847) 624-2832
DR. DANNY LEE D.D.S.
Dentist (General Practice)
1959 NE PACIFIC STREET; BOX 357134, UNIVERSITY OF WASHINGTON DEPARTMENT OF ORAL SURGERY
SEATTLE, WA 98195
King County (253) 486-9152

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Park's NPI number?

The NPI number for Timothy Park is 1457190738. It was assigned to this individual provider in the NPPES registry on May 24, 2024.

Where is Timothy Park located?

Timothy Park practices at 1959 NE Pacific Street; Box 357134, Seattle, WA 98195. The listed phone number is (215) 285-5142.

What is Timothy Park's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Timothy Park enrolled in Medicare?

Yes. Timothy Park is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Timothy Park was last updated on October 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.