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

Dr. Samuel S Park, MD

Individual provider Anesthesiology Physician · NPI 1124551239

Dr. Samuel S Park, MD is an Anesthesiology in Kirkland, Washington. Graduated from University of Washington School of Medicine in 2017, 9 years ago. Practices with Matrix Anesthesia, Ps, a 87-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
9
Trained at
University of Washington School of Medicine
Licensed in
WA
In the registry since
2017
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

12040 NE 128th St
Kirkland, WA 98034-3013
Phone: (425) 899-3455
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence MD61147982 (WA)

Record details

NPI number1124551239
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 5, 2017
Last updated in NPPESSeptember 30, 2021
Certification dateSeptember 30, 2021
Mailing addressPo Box 4069, Everett, WA 98204-0007

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY
Medical schoolUNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduated 2017 (9 years in practice)
Group practice Matrix Anesthesia, Ps — 87 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Kirkland