Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. STACEY PARK, PHD
ActiveDR. STACEY PARK, PHD is a Child, Clinical Psychologist healthcare provider located in FIRCREST, Washington. NPI 1659801173 is currently active in the NPPES registry. Verify at CMS.
Child, Clinical Psychologist · FIRCREST, WA
Registration Details
- NPI Number
- 1659801173
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 18, 2017 (9.1992761973762 yrs)
- Last Updated
- Jun 25, 2022
- Licenses
-
PY60880262 (WA)28774 (CA)
Practice Information
- Address
-
6314 19TH ST W STE 14FIRCREST, WA, 984666223Browse WA providers · Browse ZIP 98466
- Phone
- 2532392310
- Fax
- 2532392311
- Primary Specialty
-
Child, Clinical Psychologist
103TC2200X
- Additional Specialty
- Counseling Psychologist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.