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

Peter S Park, FNP

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1154937241

Peter S Park, FNP is a Nurse Practitioner in Grandview, Washington. Qualified in 2020, 6 years ago. Practices with Prosser Public Hospital District of Benton County, a 111-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
6
Licensed in
WA
In the registry since
2020
Specialties on file
2
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

1003 Wallace Way
Grandview, WA 98930-8805
Phone: (509) 786-2222
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence AP61125867 (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1154937241
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP
Sole proprietorNo
NPI enumeratedSeptember 23, 2020
Last updated in NPPESJune 2, 2021
Certification dateJune 2, 2021
Mailing address1003 Wallace Way, Grandview, WA 98930-8805

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Prosser Public Hospital District Of Benton County — 111 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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