KATHLEEN J PARK MD
NPI 1790709582
Pediatrics - Adolescent Medicine in Seattle, WA

Q: What is Kathleen Park's NPI number?

The NPI number for Kathleen Park is 1790709582. It was assigned to this individual provider in the NPPES registry on July 26, 2006.

Q: What is Kathleen Park's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Q: When was this NPI record last updated?

The NPPES record for Kathleen Park was last updated on June 27, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.

Active since July 26, 2006PECOS Enrolled

1100 9TH AVE, SEATTLE, WA 98101(206) 223-6600 Get Directions Write a Review

NPPES record last updated: June 27, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Kathleen J Park Md NPPES

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

KATHLEEN J PARK MD (NPI 1790709582) is an individual adolescent medicine provider in Seattle, Washington, licensed in Washington (MD00040435) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790709582

Entity TypeIndividualFemale

Primary Taxonomy2080A0000X

Provider Legal NameKATHLEEN J PARKCredential: MD

Location Address1100 9TH AVESeattle, WA 98101-2756

Mailing Address1100 9th Ave, Ms:m4-paSeattle, WA 98101-2756 · (206) 515-5811 · Fax (206) 515-5886

Phone(206) 223-6600

Sole ProprietorNo

Enumeration DateJuly 26, 2006

Last NPPES UpdateJune 27, 2008

✔ NPI 1790709582 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080A0000X

License✔ Licensed in WA · MD00040435

Definition

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

1100 9TH AVE, Seattle, WA 98101

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Other Identifiers 6

OtherUS7466375WA · Aetna/ushc Pin

Medicare UPINH63287

Medicaid8321358WA

Medicare PIN8860885WA

Other0039577WA · L&i

Other9071PAWA · Individual Blue Shield

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathleen J Park Md 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 20

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

JACLYN ANN SUBKOVIAK OT

Occupational Therapist

1100 9TH AVE
SEATTLE, WA 98101

King County (206) 341-0461

MARCIE G HUME PHARM.D.

Pharmacist

1100 9TH AVE, MS C3-PO
SEATTLE, WA 98101

King County (206) 223-6877

DR. VINAY GUPTA MD

Internal Medicine (Critical Care Medicine)

1100 9TH AVE
SEATTLE, WA 98101

King County (206) 223-6980

MARY JO BUKOVIC CCP

Contractor

1100 9TH AVE
SEATTLE, WA 98101

King County (206) 223-6600

PEGAH SAFAEIAN D.O.

Physical Medicine & Rehabilitation

1100 9TH AVE
SEATTLE, WA 98101

King County (206) 223-6600

MRS. GENEVIEVE HOUDET-COTE SLP

Speech-Language Pathologist

1100 9TH AVE, MS:H4-PMR
SEATTLE, WA 98101

King County (206) 341-0461

ROBERT DALE MCCLURE MD

Surgery

1100 9TH AVE
SEATTLE, WA 98101

King County (206) 223-6600

VIRGINIA MASON MEDICAL CENTER

Internal Medicine (Gastroenterology)

1100 9TH AVE
SEATTLE, WA 98101

King County (206) 223-6600

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 Kathleen Park's NPI number?

The NPI number for Kathleen Park is 1790709582. It was assigned to this individual provider in the NPPES registry on July 26, 2006.

Where is Kathleen Park located?

Kathleen Park practices at 1100 9th Ave, Seattle, WA 98101. The listed phone number is (206) 223-6600.

What is Kathleen Park's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is Kathleen Park enrolled in Medicare?

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

What insurance does Kathleen Park accept?

Health plans from PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Kathleen Park as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kathleen Park was last updated on June 27, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.