Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Benjamin Ross Park, DO

Individual provider Diagnostic Radiology Physician · NPI 1770922676

Benjamin Ross Park, DO is a Diagnostic Radiology in Bothell, Washington. Graduated from Michigan State University College of Osteopathic Medicine in 2013, 13 years ago. Practices with Centra Medical Group LLC, a 717-clinician group and accepts Medicare assignment. Licensed in Colorado and Virginia.

Years since qualifying
13
Trained at
Michigan State University College of Osteopathic Medicine
Licensed in
CO, VA
In the registry since
2013
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

22100 Bothell Everett Hwy
Bothell, WA 98021-8431
Phone: (208) 416-2932
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence DR.0061359 (CO)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 0102205720 (VA)

Record details

NPI number1770922676
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 24, 2013
Last updated in NPPESDecember 4, 2023
Certification dateDecember 4, 2023
Mailing address669 Carved Ter, Colorado Springs, CO 80919-1130

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolMICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2013 (13 years in practice)
Group practice Centra Medical Group Llc — 717 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations26 on file with Medicare

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