Provider Demographics
NPI:1093471823
Name:PARK, CHRISTOPHER JIN-SU (LMHC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JIN-SU
Last Name:PARK
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 NW 36TH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4959
Mailing Address - Country:US
Mailing Address - Phone:206-593-8968
Mailing Address - Fax:
Practice Address - Street 1:3035 14TH AVE W APT 7
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-2051
Practice Address - Country:US
Practice Address - Phone:206-530-4821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61673954101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health